Doctors in 3:D Psychiatry meets ‘Star Trek’

Sarah Mandzen admits she was skeptical: She would sit in a medical office on San Juan Island. Her psychiatrist would sit in an office in Everett.

They would hold counseling sessions even though they’re separated by more than 70 miles and a long ferry ride.

Mandzen is one of a handful of people benefiting from a groundbreaking use of technology, something that sounds like it’s straight from a “Star Trek” episode.

The program, being pioneered by Compass Health in Snohomish County, provides a hologram-like image that makes it feel as if the patient and psychiatrist are in the same room.

In her sessions, Mandzen would sit in front of a 32-inch television screen. The TV image she would see of her psychiatrist, Dr. Michael Shen, wouldn’t just be sharp and clear, he would appear in 3-D.

“Oh, this is going to be hokey,” she remembers thinking.

She changed her mind within minutes of her first counseling session.

“As soon as he said, ‘Hello,’ it was like you were right there with him,” she says. “You forgot about the system being there and just focused on the doctor. You forgot you were sitting in front of the machine.”

Doctors and psychiatrists have long used videoconferencing to treat patients from afar. What’s different about this project is that Compass psychiatrists are using next-generation technology, originally developed for corporate boardrooms. It produces a 3-D image allowing both psychiatrists and their patients to feel as if they were looking into each other’s eyes.

“You do get the eye contact,” Mandzen said. “The doctor really is in the room with you — that’s the way it feels.”

The technology could help bridge the gap between psychiatrists and patients who live in rural areas, who often go without services. With a national and even international shortage of psychiatrists, this technology could be key piece to the puzzle of providing help for many in need.

Compass Health an ­Everett-based nonprofit providing counseling services in Snoho­mish, Island, Skagit and San Juan counties, launched the program in December with a $375,000 federal grant.

It’s one of the first, if not the first, use of 3-D technology in psychiatry nationally, said Jon Linkous, executive director of the American Telemedicine Association in Washington.

“We’ll be eager across the country to find out the results of their work,” Linkous said.

So far, 23 patients ranging in age from 17 to 87 are enrolled in the program, which serves San Juan County. The patients are being treated for problems such as anxiety and depression.

Beginning next month, psychiatrists at Children’s Hospital and Regional Medical Center in Seattle will use the same technology to provide services to children in four rural counties in Eastern Washington.

The program, called 3D TelePresence, was demonstrated at a national health care and technology conference in Orlando, Fla., in February. Dr. Bill Crounse, Microsoft’s senior director of worldwide health, wrote about it on his blog.

“I think we’re just at the tipping point for what I forecast will be an explosion of these kinds of services … both in the developed and the undeveloped world,” he said.

Mental health and psychiatry are just two examples of how technology is being used to provide medical information and services far more efficiently, Crounse said.

Money, time saved

Until now, Compass Health had to fly a psychiatrist to Friday Harbor on San Juan Island once a week to provide services to its patients. Travel costs hit about $11,000 each year, said Tom Sebastian, Compass president and chief executive.

Although the new 3-D technology allows psychiatrists to spend more time with patients instead of commuting, Dr. Shen wondered if he would miss subtle cues that often provide insights during a counseling session.

Instead, some patients said they were more comfortable and less intimidated than they would be sitting in the same office with a psychiatrist, he said.

The main purpose of the project “is to figure out a way to reach out to patients who otherwise would be left out,” Shen said.

Without the service, many San Juan County patients would have to take the ferry to the mainland, then drive to a psychiatrist’s office in Burlington, Bellingham, Everett or the Seattle area, said Carrie Burke, a project assistant for the San Juan County Telepsychiatry Project.

That’s the situation Mandzen would face without the Compass program. Living on the island, she doesn’t own a car.

“The setting, format, communication, the doctor … it’s fantastic,” Mandzen said.

“The bottom line: It’s a blessing to have this here.”

3D TelePresence was developed for corporate clients as a way to improve the quality of videoconferences and training sessions — a step up from HDTV.

Jess Jamieson, then Compass Health’s chief executive, had a series of talks with Duffie White, chief executive of Plano, Texas-based TelePresence Tech, which developed the technology, about other ways it could be used.

“I was describing the (national) shortage of psychiatrists,” Jamieson said. He thought the technology could be used so more people to get the services they need.

But the $100,000 price tag for the high-end, 73-inch screens being used for corporate videoconferencing put them out of reach for nonprofit organizations like Compass Health.

“I said, ‘Your units are too big and expensive. You’ve got to get the price down,’ ” Jamieson said.

Jamieson couldn’t be dismissed as yet another wide-eyed enthusiast. White is Jamieson’s brother-in-law.

White took Jamieson’s advice, developing a portable 32-inch model, a process more complicated than it might sound.

“Scale and size are tricky things in this technology,” Jamieson said. “You’ve got to rethink the math and the formulas.”

A prototype was brought to Everett about 18 months ago. “It blew everybody away,” Jamieson said. “The information technology people had never seen anything like this.”

The two units now being used in Compass Health’s telepsychiatry project, based in Everett and Friday Harbor, cost about $30,000 each.

The equipment and psychiatric services are part of a three-year pilot project in San Juan County.

Advances in Technology, a Bothell-based Compass Health subsidiary, installed and maintains the equipment used to link the Everett psychiatrist with Friday Harbor patients.

“What we’re trying to do is use this as the demonstration project,” Jamieson said. “We will have a legitimate way to say, ‘Here is a way to get additional resources and access to mental health services.’ “

Technology improves

More bandwidth, meaning higher-speed technology, eliminates the “slow modem delay” sometimes experienced on older videoconferencing systems.

“It’s not like watching those old Godzilla movies where you see the lips move and then hear the words,” said Jamieson, who now helps oversee the San Juan Island project.

The Internet broadcast link between Everett and Friday Harbor is highly encrypted to ensure patient confidentiality. “We control the videostream and know exactly where it’s going to and from,” said Rich De Brino, a vice president of Advances in Technology.

Next month, the same technology will be used for specialists at Children’s Hospital in Seattle to begin providing pediatric psychiatric services to Grant, Stevens, Lincoln and Okanogan counties in Eastern Washington.

“This is really a godsend for us,” said Roger Bauer, chief executive of Okanogan Behavioral HealthCare and Medical Clinic, which provides medical and behavioral health services in Omak. “In our part of the world, there just aren’t any options.”

Patients now have to travel to Wenatchee for such services, said Lisa Apple, a director at the Omak organization. “A lot of our folks don’t have transportation.”

Children needing treatment or diagnosis of a developmental problem can be 3, 4 or 5 years old. “It’s a two-hour drive, two to three hours to do the appointment and then another two-hour drive back,” Apple said. “You can imagine the type of day that would be.”

Jamieson has been invited to talk about Compass Health’s telepsychiatry project at the Wainhouse Research Collaboration Summit in Boston in July.

The annual conference focuses on how technology can be used to improve communication in government, health and education.

“Here we are in Snohomish County and we have this application that’s now gaining national attention,” Jamieson said. “It’s not just a local notion that we think this is a big deal.”

The technology being used in the San Juan Island and Eastern Washington projects could help bridge the shortage both nationally and internationally of psychiatrists, especially psychiatrists for children, Jamieson said.

Services to children are a critical need because early help can prevent a lifetime of problems. “Yet we don’t have the resources to address that,” he said.

“The need and demand for services will continue to grow,” he said. “The only thing I can see is using technology to fill that gap.”

Reporter Sharon Salyer: 425-339-3486 or salyer@heraldnet.com.