Dawn Sampson recently had a conversation with a television. Catalina Island Medical Center's licensed clinical social worker was discussing her patients' anticipated needs with psychiatrist Dr. Jagdeep Garewal. Garewal, who was in Bakersfield, and Sampson, who was in CIMC's Oak Room, were able to have the conversation via video conferencing equipment that is the cornerstone of CIMC's new telemedicine program.

Garewal is the first medical provider to offer services to Catalina residents via telemedicine. His psychiatric specialty dovetails perfectly with Sampson's new counseling services. The two will be able to work together to offer a level of mental health services not previously available island residents.

Sampson said that most of her patients have routine issues, such as depression, bi-polar disorder or anxiety. She anticipates that about half of her patients will need medication. "The combination of medication and therapy has been shown to be the most effective treatment for diagnoses such as depression and anxiety," she said. With the addition of the telemedicine equipment and Dr. Garewal's services, patients will be able to consult with a board-certified psychiatrist.

"A lot of emotional disorders require medications," Garewal said. "With telemedicine I can prescribe medications and monitor side effects."

In the past, island residents who needed medication for their disorders have been able to get their prescriptions through the family practice physicians at CIMC.

"For complicated cases it's a good idea to have a psychiatric evaluation," Sampson said. Telemedicine will allow Sampson's patients to get that support without a trip to the mainland.

Although telemedicine may be new to Catalina Island Medical Center, it is not new to Garewal. The board-certified psychiatrist has 10 years of experience in the technology. His first experience with telemedicine was in 1996, when it was offered as an elective during his residency program at Kansas University Medical Center.

In the spring of 2003, Garewal was able to expand his telemedicine practice when California laws were changed, allowing insurance companies to cover consultations via telemedicine. By October of 2003, he had begun offering telemedicine psychiatric services to Ridgecrest Regional Hospital from his base two hours away in Bakersfield. He also uses telemedicine to work with patients in Lake Isabella.

"There are really not any major drawbacks," Garewal said of the technology. "The patients usually like it."

Telemedicine's major benefit has been the improvement of access to underserved areas - such as Catalina.

The technology that allows Garewal to see patients in Catalina from Bakersfield can also be used for other applications. "I think telemedicine holds enormous potential for medical care on the island," Catalina Island Medical Center Administrator Bill Greene said. "It can also be used in ways not directly related to patient care."

One of those applications is in finding Greene's replacement. A nationwide search is being held to replace the administrator, who will retire at the end of the year. Initial interviews of promising candidates will be conducted using the video conferencing equipment. "The Avalon Medical Development Board of Directors will save thousands of dollars in travel expenses," Greene said. "Instead of flying 10 candidates here for initial interviews, the board will be able to narrow down the applicant pool and will only need to bring their final candidates to the island."

CIMC continues to explore the world that telemedicine has opened up. "This technology opens up a new world of patient services," Greene said. "Psychiatric services are just the first of many new services we'll be able to offer our patients."

For more information visit www.CatalinaIslandMedicalCenter.org