Telehealth services depend on quality broadband network communications. Recent legislation, executive orders, and agency funding commitments and grants are set to make a significant impact in terms of expanding and improving telehealth services and broadband availability and reliability in the southwest region and nationally.
At this time of year, I feel it is important to take the time and reflect on what makes us happy, and what we are you thankful for. I am truly thankful for my family and friends. I am also thankful to be working in telehealth with the Southwest Telehealth Resource Center. Through telehealth I’ve met some amazing people and I’ve reached out to some of them and asked them to help celebrate this season of Thanksgiving by sharing what they are thankful for. Hopefully their thoughts will inspire some of you and maybe even make you smile. All of us at SWTRC wish you and yours a wonderful thanksgiving holiday!
Telehealth has many benefits including reduced, or eliminated travel and wait times; decreased exposure to communicative diseases; easier access to healthcare professionals and therapeutic interventions; and greater flexibility. However, for many individuals with disabilities, Telehealth and it's associated benefits may be out of reach due to web inaccessibility. Benefits can become barriers because of websites’ inconsistent compatibility with screen readers, closed captions, magnifiers, speech to text software (used by individuals with limited dexterity), easy to understand instructions and hyperlinks (for individuals with cognitive disabilities), and alternative text formats.
Does it surprise you that some clinicians are NOT all that excited to continue to provide care without being in the same room with a patient? Virtual care includes care by video, telephone, email, text/chat, remote monitoring, social media, mobile apps, artificial intelligence and more! More than a decade ago, when I implemented video visits for one region of a large healthcare organization, one-to-one training was provided to approximately 1000 physicians, Advanced Practice Nurses and Physician Assistants who provided scheduled, outpatient care - primary care, medical and surgical specialties. Each of the trainees was given a webcam. One year after training was completed, only 70 of these trained clinicians had provided care by video at least once. Note that reimbursement was not an issue for these clinicians. They were and still are salaried, with incentives based on clinical outcomes and patient satisfaction.
Let’s do more interprofessional consultations! And let’s start by calling them e-consults.
What are e-consults?
Electronic consults (e-consults) are asynchronous clinician-to-clinician exchanges that are used when there is not a need for a face-to-face (in person or telehealth) visit between a clinician/specialist and a patient. Under the umbrella of telehealth, e-consults are considered a store and forward option that uses telephone, Internet and/or an electronic health record (EHR). Patient information that has been gathered and documented is provided by the treating/requesting clinician to a consultative physician with a request for medical advice and/or an opinion. According to the Centers for Medicare & Medicaid Services (CMS) “…these inter-professional consults are typically initiated by a primary care practitioner to a specialist for a low acuity, condition-specific question that can be answered without an in-person visit. CMS also considers e-consults as assessment and management services.