How Telehealth Is Making Care More Accessible In Remote Regions of the US

AAFP to FCC: Improve Rural Telehealth to Support Primary Care

By Rahul Varshneya, founder and president, Arkenea.

Rural communities, often located amid isolated yet beautiful landscapes, are a defining feature of much of the United States of America. But those same landscapes can, at times, make it arduous for people to gain access to something as basic as a healthcare facility.

In these regions, patients are often tens of hundreds of miles from the location of their nearest caregiver. Community hospitals, with limited budgets and low volumes, generally don’t have specialists. And even if they do, there are too few to ensure constant coverage.

Telehealth is transforming these situations to everyone’s advantage. 

A recent study of Intermountain’s neonatal telehealth program evaluated the effect of video-assisted resuscitation on the transfer of newborns from eight community hospitals to newborn ICUs in Level 3 trauma centers. The service produced a 29.4% reduction in a newborn’s odds of being transferred, which corresponds annually to 67 fewer transfers — and estimated savings of $1.2 million for affected families.

By leveraging telehealth, patients can receive expert treatment locally without the added cost and risk of transfer to a bigger hospital. Local hospitals retain vital revenue and ameliorate their services. Community members get better care that’s based on evidence-based best practices. Health care is far better overall.

In this piece, we will be looking at a few ways telehealth is improving patient experiences and making care more accessible in remote regions of the United States.

1) Bringing Patients and Care Providers Closer for Better Outcomes

Most patients in the rural or suburban settings of the southwest, like the ones living in the remote terrains of Nevada, lack the necessary resources to travel to a healthcare facility. 

Even for patients living in the urban areas, public transportation can be grueling and tedious. Less mobile or older patients might also not always have family or acquaintances who can be their caretaker and take them for frequent clinical visits. 

Telemedicine can help such patients feel more independent. One study found that the use of a specific home-telemedicine strategy for care coordination improved functional independence in non-institutionalized veterans with chronic conditions.

Not only does telemedicine adoption help patients manage their conditions, it is equally beneficial for healthcare providers too.

Hospitals, clinics, public health offices and private practice healthcare providers in the southwest have been receiving free technical assistance for implementing or expanding their current telemedicine programs from various government authorities for quite some time now.

Since laws governing telehealth and reimbursement greatly differ by state, various Telehealth Research Centers (TRCs) spread across the country help providers discover the latest telemedicine and telehealth laws and regulations that apply in the state where the provider’s practice is based.

TRCs are also helping providers – generally free of charge – in developing a business model for telehealth in their healthcare setting, selecting the appropriate telemedicine platform as well as equipment, and providing education to patients alike on how to leverage telemedicine technologies to improve health outcomes and access to healthcare services.

2) Improved Self Management of Chronic Conditions

According to the latest CDC Report, in the United States alone, 30.3 million people (about 1 in 10) have diabetes. 

To complicate things further, rural populations possess higher rates of diabetics and lower rates of individuals participation in self management programs compared to the ones residing in urban areas.

Telemedicine programs such as diabetes self-management education and support (DSMES) services are helping people in the rural regions manage their diabetes by staying active, eating healthy food, keeping a check on their blood sugar levels, handling stress and taking prescribed medicines on time. 

Industry experts believe that such programs are highly efficient in improving overall health of patients and reducing the complications caused by it. These are also extremely cost-effective for employers, insurers, and the US healthcare system as a whole. 

Similarly, telemedicine can make hypertension management easier and result in greater levels of patient compliance. Timing of medications in hypertension is crucial for improving patient outcomes. Healthcare practitioners can schedule regular follow-up visits with the patients to ensure the medication schedule is adhered to. Patients can also get automated medication reminders through the telemedicine app to improve the compliance levels. 

Additionally, these programs are also aiding remote care providers in training patients to self-manage other chronic conditions such as epilepsy, heart disease and stroke, and various diseases of the eye to a certain extent through telemedicine consultation and telerehabilitation services in the remote regions of the US.

3) Furnishing Treatments that are Highly Efficient and Cost-Effective

Telemedicine is rapidly providing people of rural America with greatly efficient and cost-effective solutions from the comfort of their homes. One fine example of this would be the way providers are streamlining cardiac care through telemedicine today.

The Southwest Telehealth Resource Center (SWTRC) dispenses onsite telemedicine training at the Flagstaff Medical Center (FMC). This urban facility then offers telemedicine service to its patients with congestive heart failure (CHF). 

FMC happens to be the only level 1 trauma center north of Phoenix and the nearest hospital for many northern Arizona residents. But the majority of patients may still need to travel several hours to reach it.

With CHF”, SWTRC co-director Dr. Ronald S. Weinstein said, “You can prevent readmissions to hospitals just by having people check their weight once a day.

However, hogans (traditional Navajo homes) don’t have electricity supply, so the residents can’t charge the electronic scales used in similar CHF programs. So, the Flagstaff Medical Center provides each CHF patient with a special electronic scale, a satellite phone to provide service in areas without cell towers, and solar panels to charge the scale.

Patients step on the scale once a day, and the scale transfers the information to a dashboard monitored by the FMC. Patients who have gained two pounds since their last weigh-in are asked to adjust their diet, and patients who have gained three pounds are asked to take an additional diuretic tablet. 

Weinstein reports that taking this step allows a patient to avoid emergency hospitalizations, often costing as much as $93,000 in a year. “I would say that’s telemedicine in its simplest form,” said Weinstein, “and yet with an enormous yield.

Closing Words

Telehealth adoption has exhibited remarkable potential in areas like chronic condition management, remote patient monitoring, and delivering behavioral care in a cost-effective manner, especially during the ongoing COVID-19 pandemic.

While the advancements in research for this field are growing as we speak, it goes without saying that telehealth has led to better health outcomes by furnishing early interventions and improving access to care in remote America.

Today, telehealth includes everything right from digital CT scans and remote monitoring of intensive-care units to telephone consultations and live video feeds via Skype. The healthcare industry is certainly poised for a change in the near future.

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