Telehealth, done right, could greatly benefit rural America
| December 8, 2020 7:00 AM
Rural America’s low population density provides us access to beautiful, wide-open spaces and a remarkable quality of life, but it creates significant challenges in the delivery of health care services. Folks in remote locations face a shrunken supply of primary-care physicians, specialists and emergency room doctors, hampering their efforts to seek treatment for complex concerns.
Telehealth levels the playing field.
The Leona M. and Harry B. Helmsley Charitable Trust, for which I serve as trustee, is committed to harnessing innovation, collaboration and sustainability to bring the gold-standard of care enjoyed in top cities to remote parts of seven upper Midwest states. Our partnerships continue to improve outcomes in cardiac treatment, cancer care, behavioral health services and emergency training.
We observed National Rural Health Day on Nov. 19 and I’d like to broaden the celebration to recognize that what we’re learning in rural America is transforming the way healthcare is delivered across the nation’s rural, urban and suburban landscapes. Through the Helmsley Charitable Trust’s partnership with Avera eCARE, telehealth is serving 1.5 million patients at more than 420 facilities, and its use is poised for exponential growth.
As the onset of the COVID-19 pandemic prompted many patients to rethink the need for in-person meetings, physicians have turned to telehealth to provide high-quality service in the safest settings. Medicare and private insurers have traditionally resisted reimbursing providers for virtual visits at the same rate as in-person appointments, but COVID has prompted insurers to adjust that practice. Rural America would greatly benefit if those changes were made permanent.
Telehealth in its most basic form is similar to a Zoom call or Facetime chat, but the secure connection protects patient privacy. Even a simple camera-based virtual visit can help a dermatologist make a crucial diagnosis of a skin disease. More sophisticated connections between remote sites can integrate real-time digitally delivered vitals, labs, health records, heartbeat monitoring and imaging.
Remote healthcare is instrumental in saving lives, particularly in emergency room settings. Many rural hospitals and clinics lack board-certified emergency room physicians, leaving trauma care in the hands of family medicine physicians, nurse practitioners and physician assistants. eCare Emergency connects local providers with top-notch ER doctors who can help diagnose patients, advise on complex ailments and act as sounding boards for boots-on-the-ground medical providers.
In a typical stroke case, a rural patient would have to be transferred to a hospital hours away, stealing valuable time that could improve outcomes. In an emergency department equipped with telehealth services, a local doctor consults remotely with a neurologist, who could diagnose the type of stroke and advise on the administration of life-saving clot-busting drugs. And this type of telehealth is saving lives from not just strokes, but also heart attacks, obstetric emergencies and other trauma.
One of the greatest barriers to increased telehealth use has been the lack of broadband Internet connectivity. Without access to high-quality connections, rural areas are limited in the technologies they can adopt. We need to ensure that everyone can access the best care.
As I celebrate the advances in telehealth’s use, I would be remiss if I didn’t express some of my concerns with this rapid growth.
I worry that physician groups and others enticed by a potentially lucrative operation could set up shop without insisting on the same quality standards established by the Helmsley Charitable Trust and our partners. If patients have negative outcomes because operations fail to ensure superior physicians, training or platforms, it could set telehealth back for decades. Agencies would respond by stepping up regulation, and payers might refuse reimbursement because they would no longer see telehealth as a quality service.
To help ensure a gold-quality standard for telemedicine, the Helmsley Charitable Trust has partnered with the American Board of Telehealth (ABT), Avera Health and several other organizations to create the CORE Concepts in Telehealth Certificate Program, providing important training. If physicians, physician assistants, nurse practitioners, nurses and hospital administrators can agree on defining quality and laying out how to achieve quality, they’ll be better able to deliver quality.
Overall, I’m excited about the future of telemedicine and see endless possibilities for its expansion.
Rural school districts commonly struggle to staff individual schools with nurses, often asking a single nurse to cover multiple locations. And when that nurse can’t be everywhere, office staff members are tasked with caring for kids dealing with diabetes or asthma. The eCare School Health program allows nurses to visit virtually with students, ensuring that trained professionals treat and manage care.
In jails and prisons utilizing eCARE Correctional Health across the upper Midwest, prisoner transports have decreased by as much as 60 percent, improving healthcare quality while saving money and increasing public safety. To improve law enforcement’s access to behavioral health services in the communities they serve, the Helmsley Charitable Health launched a program that uses tablets to connect officers with mental health professionals in real time, diffusing potentially volatile encounters.
And we’re seeing science-fiction-level technological advancements once only dreamed about. It’s just a matter of time before remote surgeries mature into a common reality, expanding the footprint of more crucial services.
So, I encourage everyone to celebrate National Rural Health Day, as what we’re learning in rural communities can further innovate practices in our nation’s core urban centers and throughout suburbia.