About Us

   Usage

The AFHCAN system has been deployed on 42 servers throughout Alaska. More than 17,000 cases have been created, of which 13,307 are real clinical cases that have been archived (see table at right). The remaining cases are either used for test / training purposes, or are open cases that are being reviewed by clinicians. The numbers have been steadily increasing - from 721 cases in 2001, to 2,843 cases in 2002, then 8,136 cases in 2003. The majority of these are Primary Care cases sent from community health aides to family physicians. The second most common consultations are ENT cases sent from audiologists or physicians to otolaryngologists. The third most common consultations are Dermatology cases sent from physician assistants, nurse practitioners and physicians to dermatologists. In 2003, there were 6,589 Primary Care, 1,235 ENT, and 312 Dermatology cases archived in the software. Equipment usage is shown in the table to the left. For the 13,307 real and archived cases, approximately 47% of these cases involved the use of the video otoscope, 42% involved a digital camera, and the scanner was involved in 23% of the cases. The EKG is used less often (7%) – but is most likely used in critical or urgent cases. While electronic forms are used infrequently, the ability to type a “free form” comment in a case is used extensively (53% of cases).

Usage of the system varies extensively among organizations and among sites and users. Some users have created few cases, whereas others have been involved in hundreds of cases. Usage amongst providers depends significantly on clinic workload, specialty, organizational practices, and a myriad of other factors. The plot to the right indicates the broad spread of usage by providers. Interestingly – many providers are able to use the system effectively at a low usage rate. In a small clinic with limited workload (less than 100 encounters per year), the clinicians may use the system less than once per week or month. More complex telehealth systems have been found to fail whenever usage drops below a critical level as the required user skills are diminished. The simplicity of the AFHCAN system allows for low utilization rates without loss of critical skills.