The University of Missouri Department of Pathology and Anatomical Sciences has expanded its reach to serve 45 counties in Missouri with the addition of a contract with Greene County to provide medical examiner services to the Springfield, Mo., area.

MU medical examiners in Columbia conducted their first joint case review with scene investigators in Greene County on May 8 with the assistance of videoconferencing provided by MU’s Missouri Telehealth Network. Reviewing cases remotely allows for coordination of medical examiner services and medical education to the Springfield area, in addition to conserving financial resources, said Bud Smith, administrator of the MU School of Medicine’s Department of Pathology and Anatomical Sciences.

The department now has annual contracts to provide medical examiner services to six counties, and provides services as requested in an additional 39 counties. The addition of Greene County is noteworthy because the area encompasses the third largest city in Missouri and it provides medical examiner services for southwestern Missouri, Smith said.

“We look at it as a service to Missouri residents,” Smith said. “Expert medical examiner service is something that people need to have available to them regardless of their location. The university benefits from these contracts by being able to provide more teaching experiences.”

The department began its expansion program in 2003, and Smith has seen the number of cases significantly increase – from 170 autopsies that year to the 419 autopsies performed for 39 counties in 2008. The $1.5 million renovation of the MU anatomy morgue in 2006 added about 1,000 square feet to the medical examiner’s office located at MU’s medical school, allowing for additional autopsy tables and a larger case volume. With the addition of the Greene County contract, Smith said he expects that MU medical examiners will see an even greater increase, to an estimated 600 cases per year.

Last year, MU and Greene County began discussing the possibility of sharing a medical examiner. This agreement is beneficial for both parties because it provides an attractive caseload for a forensic pathologist to serve both areas, making it easier to recruit a qualified specialist, Smith said.

The Missouri State Highway Patrol opened a new crime lab in Springfield in February 2009 with dedicated space for Greene County to add a morgue to the facility in the coming years. According to the one-year, $355,000 contract, autopsies will be performed at MU for the first year with the exception of high-profile cases or other special circumstances. Effective Feb. 1, the three staff members of the Greene County medical examiner’s office became MU employees. Provided that the one-year contract proves to be beneficial for both Greene County and MU, the contract could be extended.

Seven Missouri counties, due to population size, are required by the state to have a medical examiner rather than a coroner. A coroner is an appointed or elected public official who may or may not have medical training, whereas medical examiners are often licensed forensic pathologists or have specific training and experience in anatomic pathology.

Boone County is one of the seven required by the state to provide medical examiner services. Skip Elkin, Boone County Commissioner, who has served as the county’s liaison to the medical examiner’s office for the past eight years, said the relationship is the perfect example of a governmental and quasi-governmental partnership.

“Higher education at the university benefits from the cases’ value at a teaching hospital, and we benefit because we’re able to utilize medical examiner resources at a fraction of what it would cost us to do it on our own,” Elkin said. “I think it’s a great testament to the top-notch services that the Department of Pathology and Anatomical Sciences provides that Greene County, which is much larger than Boone County, has sought out these services from MU.”