Everyone deserves timely access to healthcare. Unfortunately, it’s not always practical in remote areas, especially when it comes to specialty care. Fortunately, telehealth technology and the hard work of some dedicated professionals have made remote care a reality.
With a coverage area that includes Alaska, Idaho, Oregon, Utah, Washington and Wyoming, the Northwest Regional Telehealth Resource Center (NRTRC) serves as a prime example. The NRTRC provides free unbiased information and technical assistance to anyone interested in telehealth. “As part of a 14-member consortium, we provide access to the best minds in telehealth,” says Bob Wolverton, Billings, MT-based program director of the NRTRC.
Within the NRTRC coverage area, remote populations are the norm. As such, residents, especially within Frontier states like Alaska and Wyoming, often need to drive as many as six hours for specialty care. “When a town of 2500 people is 45 miles from the next nearest town of 2500 people, it’s not feasible to support a specialist,” says Wolverton. “Our goal is to help overcome the distance-based challenges.”
Case in point
When remoteness and low populations are the reality, it’s difficult for people to get prompt medical care, which can unfortunately result in people forgoing needed care. This is especially true in communities where only a physician’s assistant or nurse practitioner is available.
However, with collaborative technology and telemedicine, patients can more easily access a primary care doctor or a specialist. “Consider for instance, the care center who recently treated a woman who was suffering from an extreme headache while working in her garden. Her husband got very worried, very quickly, and called the hospital to let them know that they were coming in. By the time they arrived, the hospital was ready to bring her in, anticipating a stroke,” says Wolverton.
“They did some scans, and sent the images electronically to the local university. The university’s neurologist then consulted with the patient using telemedicine. They discussed the probability that TPA would help break up a clot, and it was administered by the local hospital. In this instance, the patient could go home the next day. This is a great success story because the patient received the care she needed without incurring a $30K helicopter ride, or ancillary expenses associated with a stay in the big city.”
There’s another instance of a rancher who sustained a substantial injury, and went to his local critical care hospital where a primary care physician was covering the ER. The injury was beyond what the primary care physician felt comfortable handling, so he connected via video with an emergency provider who helped him through triage and suturing the wound. Again, telehealth helped avoid the expenses and risks associated with transporting the patient to a big city facility.
State of Telehealth in the Northwest
Bottom line: Telehealth technology is constantly evolving, and as a result, it’s playing a crucial role in helping patients within the Northwest region with much needed access to care. “However, there’s a dire need to let the public know that telehealth is available,” says Wolverton. “If they don’t know that they can ask to see a remote specialist they never will.”
Of course, the key to expanding telehealth is funding. “Although grants available today are very tailored, they will continue to play a key role going forward because they help providers find best practices for particular disciplines,” he says. “Success starts with convincing leadership that rather than being a cost center, telehealth presents an opportunity to drive more revenues through the ability to provide more local services.”
There’s also a need to educate providers on telehealth’s role. Specifically, telehealth is not going to take away their ability to treat patients. “They do not need to surrender to someone on a TV screen in another city,” he says. “Instead, telehealth allows for a cooperative arrangement between a specialist and a local provider.”
The focus needs to remain on strategically placing more telehealth access points into existing care centers, explains Wolverton. “Beyond the direct to patient movement where people can remotely seek primary care for non-acute situations, we need to see more specialty care collaboration with local primary care providers,” he says. “It’s this environment that allows patients to see specialists when needed, while the primary care provider has the opportunity to receive valuable coaching and collaboration from someone with unique skills.”
Wolverton has a clear vision for how he would like to see telehealth evolve. “Telehealth needs to be about leveraging a wealth of talents to make everything available to everyone – not just relying on specialist within a given network,” he says. One of NRTRC’s member hospitals is prime example. As a 25-bed critical care facility, the hospital has utilized telehealth to become a receiver of care from a wealth of different areas. The hospital utilizes specialists in France and Israel with both admitting privileges and licenses in the state.
“They’ve created an environment where the technology itself falls to the side to effectively support meaningful interactions between the local doctor, the specialist and the patient.”
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