Far from the hubbub of any city, the roads happily switch back and stretch for miles. But when weather shuts them down and grounds all flights, forget about seeing that specialist in Boise or your hospitalized mother in Anchorage. Even when you can get there, it takes time and costs money.
Rural areas face a shortage of medical specialists where there isn’t enough patient demand. When serious health conditions require immediate diagnosis and treatment, telemedicine rushes in.
Sticking close to home, you save on travel time and expenses. Best of all, you stay near family and friends.
If someone is hundreds of miles away in a hospital, telemedicine’s videoconferencing lets you be right by their side.
Unlike Skype, telemedicine encrypts all audio and video of the visits and consults, so it meets HIPAA requirements for privacy. Its high-definition cameras give super-close and precise visuals.
That dermatologist looking at your rash on the monitor can see the texture of every red patch. An echocardiogram couldn’t be clearer.
In the operating room, the surgeon can show a difficult incision to a faraway colleague for a second opinion. Then, via video, he or she can assure you in the waiting room that everything is going well.
Videoconferencing in the emergency department is a big area for telemedicine. Seattle-based Swedish Medical Center’s TeleStroke starts in the ambulance with patient assessment. Meanwhile, emergency department physicians within Swedish’s TeleHealth Network of 16 hospitals from Whidbey Island to Lake Chelan stand ready.
When you arrive at the emergency department, you and the doctor can videoconference with a neurologist at Swedish. What a difference that makes when he or she prescribes the drug that breaks up the clot—just in the nick of time.
Bozeman Health in Bozeman, Montana, enjoys its TeleStroke partnership with the University of Utah Health in Salt Lake City, thanks to charitable funds raised by the Bozeman Health Foundation. If a neurologist is needed at Deaconess Hospital in Bozeman or Big Sky Medical Center 45 minutes south, providers at both locations can videoconference with specialists from the University of Utah Health. Bozeman Health’s telemedicine also provides diabetes and ongoing wellness support in some of the area’s most rural communities.
“It’s been exciting and important to us to do both upstream and downstream telehealth, where we’re drawing on expertise and also sharing it with others,” says Jason Smith, executive vice president of the Bozeman Health Foundation.
By fall 2019, Bozeman Health’s telemedicine will venture into behavioral health and psychiatry.
Since 2009, St. Mary’s Hospital & Clinics has provided telepsychiatry at its Cottonwood, Idaho, site and Clearwater Valley Hospital in Orofino, Idaho. Children and teens videoconference with a psychiatrist at U of U Health, and adults with psychiatrists at St. Alphonsus Regional Medical Center in Boise.
“Together, we have eight clinics at least an hour from Lewiston, where adult outpatient psychiatry is limited,” says Shari Kuther, physician practice manager for St. Mary’s. “For kids, it’s a four-hour drive to Coeur d’Alene or Boise. That’s a full day out of school. So the idea was to see the kids and get them right back to class because many of them are at risk of having school-attendance issues.”
For years, 19-year-old Christopher exhibited violent behavior. Misdiagnosed as having ADHD, he struggled with mental health issues. After videoconferencing with a psychiatrist at Clearwater Valley, he was correctly diagnosed as bipolar, and his doctor changed his medication. Soon he was making friends, and school and home life greatly improved.
“Telepsychiatry also supports our providers, who can use it to consult with patients’ psychiatrists if needed,” Shari says. With telepsychiatry in place, St. Mary’s started using videoconferencing in cardiology, the emergency department, telestroke and intensive care.
For less serious health issues, Providence Health & Services’ Express Care Virtual app brings the doctor to you, wherever you may be. It connects you to a medical expert via video on your smartphone, tablet or computer.
Say you get the flu or just burned yourself and aren’t sure how bad it really is. A telemedicine provider can tell you if you need to be seen at a health care facility. If you don’t need to go in but need a prescription, the doctor can arrange that.
“People want their health care to be convenient, affordable and easily accessible,” says Denny Lordan, telemedicine program coordinator at Providence Health Care in Spokane, Washington. “This technology provides all of that. It also gives patients and parents greater control over their health situations and confidence in how to proceed for themselves and their children.”
Many children born with heart problems need repeated diagnostic echocardiograms, which use high frequency sound waves (ultrasound) to make pictures of the heart. That’s a lot of back-and-forth appointments. Now they can get them closer to home with Providence Center for Congenital Heart Disease’s mobile echo. The smaller, portable machines capture the images and send the data to a systemwide server.
Providence Imaging Center in Anchorage, Alaska, provides mobile mammography. So does the Breast Cancer Detection Center of Alaska, based in Fairbanks. Founded in 1976, BCDC began its mobile program nine years later.From April through mid-October, its Freightliner truck, decorated in pink, hauls a warm and cozy exam room with the latest 3-D mammography to nearly two dozen villages throughout the state.
“We’re always well received,” says Executive Director Odette Butler. “I’m glad it’s one appointment women can check off their lists that they don’t have to leave town for. A lot of people won’t leave their communities to do a preventative exam. Or sometimes, if it’s a fishing community, they can’t since that’s their sustenance.”
If BCDC mammogram technicians can access high-speed internet onsite, they send images to radiologists in Anchorage.
Rural areas everywhere are working toward reliable high-speed internet.
Meanwhile, improvements in telemedicine policy and legislation continue. Medicare and Medicaid are making headway with standardizing telemedicine reimbursement, and more hospitals and clinics are adopting telemedicine or adding to their existing services.
The healthier those are, the healthier the people who use them will be.
About the Series: This Ruralite-produced initiative spotlights health challenges in rural communities, efforts to address them and the unsung heroes behind the work. The series receives support from the M.J. Murdock Charitable Trust, which funds projects and programs in Alaska and the Northwest. We welcome story ideas at firstname.lastname@example.org.