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   Why Alaska needs Telehealth

Alaskan communities face unique challenges in obtaining access to quality health services. The state is vast -- containing 586,412 square miles. It is one-fifth the size of all other states in the U.S. combined and 2.5 times the size of Texas. A humorous example illustrating this point is that if Alaska were to be divided in half, Texas would be the third largest state in the union! Despite its vast size, the state has only about 12,200 miles of public roads – a number more akin to the transportation systems of much smaller states such as Vermont. In fact, Alaska rates 47th out of 50th in the nation for the number of road miles while ranking 1st out of 50 for overall land mass. The lack of connecting road systems results in 75% of Alaskan communities and 25% of Alaska residents being unconnected by road to a hospital. These communities must depend on other modes of transport, such as plane, boat, and snow machine to access basic medical services. Although close to half of Alaska’s population is concentrated in the Anchorage region, the State’s largest metropolitan area, 25% of all Alaskans, and 465 of Alaska Natives, live in communities of less than 1,000 people. Additionally, the state’s weather conditions are legendary. Long and dark winters characterized by snow, ice, and temperatures reaching up to 70 degrees below zero make travel to health facilities difficult or in some cases, impossible. Nearly one-third of the state lies within the Arctic Circle. Topography also slows down the delivery of services. Alaska is mountainous –17 of the nation’s 20 highest peaks are located within the state – and filled with more than 3,000 rivers, 3 million lakes, and 100,000 glaciers. Moving patients to distant medical centers through this terrain can be treacherous. Many Alaskan communities are located hundreds of miles from large, regional medical centers, and are designated as “medically underserved.” Physicians and mid-level providers are scarce in Alaska’s rural and remote locations. In 1998, Alaska ranked 48th among the states in the ratio of doctors to residents. Only Idaho and Oklahoma had fewer doctors per 100,000 people (State of Alaska Rural Health Plan, 2000). To make matters worse, the vast majority of those physicians are centralized in the state’s urban areas – particularly Anchorage, and in lesser degrees, Fairbanks and Juneau.