Not long after the system began operating, it began to pay dividends when the expertise of the specialists began to help save the lives of distant patients. Even with the now-quaint dial-up technology, the physicians could control the cameras in the other room and offer life-saving advice.
The first system was dubbed "teletrauma" by the health care professionals who worked with it. The original program has ended, but it was one of the founders of that system, Dr. Michael Ricci, who recruited Rabinowitz to assume the role of telemedicine director in addition to his regular duties.
Now there are 70 health care locations in Vermont, including hospitals, health centers and a variety of other locations and a dozen in New York's North Country all connected with Fletcher Allen.
Psychiatry, such as that practiced by Rabinowitz, is one of the regular specialties that make use of telemedicine. Others include dermatology, an in-demand specialty, and emergency consultations for severely injured children.
Telemedicine is a tool.
"The way we do telemedicine varies from specialty to specialty. Sometimes not touching you is just fine. Other times I may need someone at the distant site to maneuver a limb or to put a piece of paper in front of you with a complex pattern on it that I want you to reproduce to test your cognitive status," Rabinowitz said. "There may be other times all I need to do is have you in front of the video camera and talk with you and that may be enough."