There were 13 counties on the southeast side of (Illinois) that had no obstetrical services and very few prenatal services available, said Robertson.

RHI is a program intended to assist medically deficient communities, hospitals and clinics in Southern Illinois by planning and developing new programs to fill medical service gaps, Robertson said.

Its highest priority is (to provide) good general health care where is doesn’t exist, he said.

The governor’s office asked us to solve some health care problems and we began collaborating with the public health department, Robertson said. The SIU School of Medicine took care of the details and got the RHI on its feet, he said.

The RHI program was passed by the Illinois legislature and signed into law by Governor Jim Thompson in 1990. Funds were not appropriated by the government, however, until 1993.

When the SIU School of Medicine received the funding, the $527,000 allotment fell far short of the original request for $6.8 million.

$527,000 was peanuts, said Robertson. We had to be very selective where we spent it.

RHI administrators decided to direct the money to towns whose health care resources are below par.

The level of medical care a town can provide is rated on a scale from 0 to 3. A level 3 health care center offers specialized services, whereas a level 0 facility offers only the most basic medical services. Carbondale maintains an above average rating of 2, but many smaller surrounding communities have ratings of only 1 or 0, Robertson said.

Communities with less specialized centers often need to send patients to faraway towns, which can be a major inconvenience, he said. Those are the towns that RHI is designed to assist.

(The Initiative) was intended to develop new services in communities with little or no health care, Robertson said. We

needed to look at specific areas, specific needs, and target the money there.

The SIU School of Medicine does not provide medical services; instead, it provides broker services, Robertson said.

(RHI) helps communities to pull together health services that are necessary to their citizens, said Carl Getto, dean and provost of the SIU School of Medicine. The traditional plan of building a clinic and then hiring a physician to work there is less effective, he said.

We’re … the health care brokers for rural Illinois, said Robertson. We’re not here to supplant, we’re here to supplement.

In 1993, the town of Hardin lost its clinic to the flood, leaving two physicians and their nurses without a practice, said Getto. RHI, working with the Jersey Community Hospital and a local committee, solved the problem.

We got them a building where the doctors could continue to serve the community, he said. Before that, they were operating out of a local school.

In Lebanon, the sole physician retired, leaving the community without any local medical care, Getto said.

RHI placed a faculty member in Lebanon to continue seeing patients and provided a rural training site for resident rotation, he said.

Continuing education of physicians is another area of RHI concern.

Most physicians can handle child care problems, but if a child needs greater care, they often must be sent a long distance from their home, Robertson said. Under RHI, practitioners come to Springfield to be further educated by doctors there.

RHI administrators are developing new technologies which will revolutionize the health care industry. However, some of them are not yet available for widespread use.

The absolutely newest thing we were working on with RHI is telemedicine, said Robertson.

Telemedicine is an interactive video where the doctor sees the patient on TV, he said. It can be used for diagnosis, wound management, checkups after surgery and many other medical services.

The most important feature of telemedicine is that it would allow people in rural hospitals to be linked to Springfield, Robertson said.

If you had the smallest wart on your finger, the microscope could magnify it, and it’d be seen on a monitor 500 miles away, Robertson said.

Telemedicine is not yet ready for widespread use but will have profound implications when it becomes available, according to Robertson.

It’s still in its infant stages, he said. We don’t even know what the outer limits will be for telemedicine.

The cost effectiveness of telemedicine is questionable. Currently, specialists who perform services via long-distance video won’t be reimbursed by Medicaid.

Emergency transportation is another field upon which RHI focuses.

The proposed Airborne Regional Medical Specialists Program would transport doctors whose services are in high demand to various clinics via helicopter on a rotating basis to diagnose and treat patients, Robertson said.

You have very expensive, busy people and this way you could move them efficiently, he said.

The system would use the state’s helicopter system, Robertson said.

It’s another piece of the system, and you’ve got to have all of the pieces to make it all work, he said.

Despite all the work RHI administrators have done, Southern Illinois health care deficiencies are far from being eliminated, Robertson said.

There are no quick fixes, he said. You don’t fix this overnight.