American Samoa's Hospital is unable to afford the telemedicine capabilities that are now possible from a new undersea fibre optic cable.
The Tropical Medical Centre's Chief Executive, Patricia Tindall, says the LBJ hospital's equipment budget is zero but management is working with Hawaii providers to acquire video conferencing technology.
The new cable has given the hospital's medical library faster access to information, and boosted tele- education programmes.
But Patricia Tindall says the hospital has unresolved financial issues such as payment for tele-health programmes and legal issues, including medical malpractice coverage and insurance.
