The future is near, say health industry insiders here who are anticipating a plethora of technological advances across many fields, ranging from video consultations to robotically assisted walking exercises.

Brian Hoots, an analyst at Northwest TeleHealth, says he expects telemedicine will play a growing role in health care in coming years.

Northwest TeleHealth is a division of Spokane-based nonprofit Inland Northwest Health Services. It includes a videoconferencing network of more than 100 Inland Northwest health-care providers that is used for interactive patient consultations and health education and training.

Hoots predicts telemedicine will provide patients a key conduit to health-care specialists, while helping patients in outlying areas remain in their communities.

Northwest TeleHealth now is targeting individual physician offices to increase provider and patient access to videoconferencing and medical information. Uses of the technology range from confidential consultations with physicians, the equivalent to an office visit, to training medical teams in classroom settings, he says. Providers often can control the camera angle to view a patient or situation.

Telemedicine is proving to be more convenient and cost-effective for patients who otherwise would have to commute from rural areas to see providers face to face, Hoots says.

While telemedicine won't fill the roles of hospitals and health clinics, many participating specialists agree there is no need for a patient to travel far from home for consultation if a provider has videoconferencing capabilities, he says.

"If more care can occur in the patient's community, it can lower the overall health-care cost model," Hoots says.

He says patients generally accept the videoconferencing technology.

"They are happy they are getting additional care," he says.

The use of surgical robots is expected to become more common as physicians learn to use them for more procedures.

In the emerging field of robotic surgery, Dr. Renu Sinha, a surgeon at Spokane-based Rockwood Clinic PS, recently trained at University of Texas MD Anderson Cancer Center, in Houston, to perform thyroidectomies using the da Vinci Surgical System.

In robotic surgical procedures, a surgeon manipulates four or five robotic arms from a console in the operating room using handheld joysticks and foot pedals, while monitoring magnified three-dimensional images provided through a tiny binocular camera held by one of the arms. The robot's other arms have wrist-like joints and "hands" that hold specialized devices, such as blades, retractors, and cauterizing equipment.

"The visualization with the robot is amazing," says Sinha, who will begin performing thyroidectomies using the da Vinci system at Deaconess Medical Center here as early as next week. "You can see nerves and surrounding structures better."

She says the surgeon is still in control of the operation.

"It probably provides more surgeon control," she says of the robotic system. "It gets rid of surgeon tremor and it streamlines motions."

The robotically assisted thyroidectomy procedure allows for a smaller, hidden incision near the armpit, compared with open neck surgery, which leaves an obvious scar, Sinha says. The robotic procedure also promotes quicker healing than open surgery.

The new procedure might take longer at first to complete, but as she gains experience with the robot, she expects surgery time for robotically assisted and open procedures will be similar.

The da Vinci system originally was used for heart and prostate surgeries, followed by certain hysterectomies.

Spokane Ear, Nose & Throat Clinic PS recently formed a partnership with Providence Sacred Heart Medical Center and Children's Hospital to offer advanced robotic surgery for certain throat and neck procedures.

Someday it might be possible for a surgeon to control the robot from an off-site location, Sinha says.

"We're not there, yet," she says. "Direct contact is very helpful, and you have to have a surgeon at bedside."

Another technological advance here involves a different kind of robotic equipment recently acquired by St. Luke's Rehabilitation Institute, in Spokane, says physical therapist Chris Clutter.

The equipment, called a Lokomat, is a body-weight supporting treadmill system with leg attachments that robotically provide walking motions for people with paralysis or other motor-control impairing conditions, such as multiple sclerosis.

The system supports the patients and mechanically moves their legs on a treadmill to simulate walking.

"It's a nice first step for people to feel normal body movement," Clutter says.

The equipment has the potential to help patients with incomplete paralysis recover movement, she says.

"If it's done quickly after an injury, it can help form new nerve connections and increase recovery speed," she says.

St. Luke's also expects to see growth in demand for its electrical-stimulation bike, Clutter says. The device uses electrical impulses to stimulate leg muscles to pedal a stationary bike.

"It's not voluntary movement, but it's good for muscles," she says.

The e-stim bike promotes cardiovascular health, she says. "People who have paralysis have a hard time getting cardiovascular workouts," she says.

Patrice Sweeny, the director of the neonatal intensive care unit at Deaconess Medical Center, says she's seeing technological advances that will improve survival rates and quality of life for frail infants.

One such recently employed technology involves a cooling system designed for use on oxygen-deprived newborns.

"It's making a huge difference in the lives of babies who are deprived of oxygen," she says.

The system includes cooling blankets that are connected to a precision cooling system that regulates the baby's temperature at 92.3 degrees for 72 hours.

"It slows down processes in bodies and prevents long-term damage to the brain and kidneys," she says.

While that new system would be used most often on full-term babies, Sweeny says she's also seen constant advances in treating premature babies.

"Every day I'm amazed at new things coming out," she says. "We just started a new product in the nursery with IV lines to help prevent infections."

A lot of advances involve small changes, such as reducing light and noise in the neonatal unit to help avoid overstimulating premature babies, Sweeny says.

Northwest MedStar, INHS's critical care medical transport service, says it expects to increase its airplane access to regional airports through a recently developed vertical guidance component of the global positioning system.

The enhancement, called Wide Area Augmentation System (WAAS), was developed by the Federal Administration System, says Eveline Bisson, Northwest MedStar's director.

WAAS uses a network of ground-based reference stations to calculate corrections for vertical guidance in variations in GPS readings from satellite signals. The system allows pilots to rely on GPS for precision approaches to any airport within its coverage area, enabling them to land airplanes in low-visibility conditions that otherwise would prevent them from accessing certain airports at times.

At Spokane Community College, electronics engineering technology instructor Larry McNeese is leading efforts to get the medical imaging industry to recognize the school as a source of future imaging engineers.

Imaging engineers maintain and support medical imaging equipment such as X-ray, computed tomography (CT), and magnetic resonance imaging (MRI) equipment, McNeese says.

The college's biomedical equipment technician program currently prepares students for entry-level positions to maintain nonradiological equipment, including defibrillators, infusion pumps, and patient monitors.

Biomedical equipment technicians typically work in the field for about five years before they're invited to participate in advanced training to become medical imaging equipment technicians, McNeese says.

The college, though, hopes to give students a leg up at SCC's recently opened Jenkins Wellness Center, he says. The center includes one fully equipped X-ray room that's used by the college's imaging department and another room that's shielded and ready to receive additional MRI and CT equipment.

McNeese says he hopes that any additional equipment would be shared by the college's imaging department and biomedical equipment technician program.

"We're hoping (biomedical equipment technician students) will be able to get enough information through our program that they might be invited to become imaging techs right away," McNeese says.

The college is soliciting equipment donations from local medical-industry sources, he says.

"In the next two or three years we hope to have all of the rooms filled up," McNeese says. "That will be a big step for a community college. Most universities don't have the facilities we have."