For many Americans, their first personal experience of being a hospital patient quickly becomes a crash course in the importance and value of having a skilled and dedicated bedside nurse. At a higher level, this points to the importance of a sufficient nursing staff which impacts the entire workflow of the hospital. Without sufficient bedside nurses, patients in the Emergency Room and Intensive Care Units cannot be moved to the floors, resulting in longer waiting times for care for those newly arriving. Beds that cannot be staffed are beds that do not exist for all practical purposes. Unfortunately, a shortage of nurses has long been a problem for hospitals across the United States. The coronavirus pandemic has brought this challenge to an entirely new level, resulting in a request by the American Nurses Association that the U.S. Department of Health and Human Services declare the current nursing staffing shortage a national crisis.

The United States and the world have seen a dramatic increase in the use of telemedicine since the inception of the COVID-19 public health emergency due in most part to stay at home restrictions for both providers and patients. Prior to this, telemedicine was used in a wide variety of clinical and related patient care applications for at least 30 years, and had been seeing steady but not exponential growth. In many cases programs were initiated quite rapidly using readily available and often low-cost equipment and tools, unless there was already an existing program and platform in place. Further, the use of telemedicine was facilitated at the state and federal levels but widespread waivers and measures being put into place to reduce barriers that were previously in place such as changes in reimbursements, requirements regarding patient and provider locations, cross-state licensure and privacy/security requirements.

How can we make sure telehealth processes are making a difference that matters? Having led virtual care for Kaiser Permanente Colorado, what matters most to me is that we are finding ways to make care less expensive and/or with better clinical outcomes. We have some proof that telehealth improves clinical outcomes. Video visits significantly decrease no-shows for mental health care. Remote patient monitoring significantly increases patient engagement in managing chronic disease. Most trust that no-shows and patient engagement are good surrogates for improved outcomes. However, the evidence that telehealth processes lead to decreased cost and/or improved clinical outcomes is less clear.

No – not that first time! How was your very first telemedicine visit? Since the beginning of the COVID pandemic back in March a significant number of people have had their very first telemedicine visit. Surprisingly, even though I’ve been involved in telehealth for over 30 years, I actually fall into that group of “newbies”. I am very fortunate (knock on wood) to be overall quite healthy. My typical medical routine consists on an annual physical, annual mammogram and dental check-ups every 6 months for the most part. Breaking my leg skiing in 2019 – trust me – that surgery could not have been done remotely and the rehab really required all the cool tools and devices my physical therapist had on site.

In May, the Navajo Nation surpassed New York and New Jersey for the highest per-capita infection rate of COVID-19 in the US. In an area where 30 to 40 percent of residents don’t have running water and families live together in multigenerational homes, containing the spread has been difficult. In addition, residents can’t stay at home and see a healthcare provider using telemedicine, as so many of us have been able to do during the Public Health Emergency, because there’s little to no cell service or internet availability. So anyone needing healthcare or showing symptoms of COVID-19 has to travel to one of the few healthcare facilities.

Starting off as a fellow with the Arizona Telemedicine Program this past June, it got me more and more interested in the specific jargon of telemedicine. At first I often used terms like “telehealth” and “telemedicine” interchangeably but as I got more heavily involved in the literature I realized they are two distinct terms. Telehealth is a more general term encompassing a larger umbrella of services, like hospital administration and training via technology; while telemedicine specifically refers to clinical services provided at a distance.

In a world of go-go-go, telerehabilitation is a way to slow down and connect with a physical therapist from your own home. This one-on-one video appointment allows a physical therapist to connect virtually using technology such as your smart phone or computer. As a functional movement profession, many people are surprised to hear physical therapy can be done through video. Truth is, this has been done for years.

The Arizona Telemedicine Program (ATP) is excited to announce the launch of its new Southwest Telehealth Resource Center (SWTRC) website! We’ve been working hard to update it over the last couple of months. The new website offers updated content, loads quickly, has improved navigation, and features a mobile-device-friendly responsive design.

Dr. Valentin Rivish, Director of Telehealth, at the Phoenix Veterans Health Care System, has introduced a telehealth program that will enable Veterans in rehabilitation to continue their physical therapy in their own homes, while connecting with their V.A. health care providers. The program is called V.A. Video Connect.