Patients

The remarkable lifelong health benefits of breastfeeding for both a breastfeeding parent and their child are well-known, and include a reduced risk of obesity, diabetes, breast cancer, early childhood illnesses and autoimmune diseases, to name just a few. Most new parents intend to breastfeed their child, and 83.2% of newborns in the US start out receiving some breastmilk initially, but according to the CDC’s 2022 Breastfeeding Report Card, only 24.9% of infants in the United States are exclusively breastfed at 6 months of age as recommended by the American Academy of Pediatrics.

Early in the Covid lockdown in Las Vegas, Dr. Luis H. Medina-Garcia was front and center of almost every press conference and community conversation.

The public health emergency (PHE) put the infectious diseases specialist at the University Medical Center of Southern Nevada in the middle of Clark County’s planning and communication efforts and forced him and his colleagues to finally take that deep dive into an area of practice they had eagerly discussed many years prior to the pandemic–telemedicine.

In April 2017 Summit Healthcare started a multi-disciplinary program to treat patients with chronic and acute pain in the White Mountains of Arizona. Our patient service area is HRSA-designated as having a shortage of providers and medically underserved. The area is the size of Rhode Island and includes Native American reservations and other vulnerable populations. Many of our patients live in a high poverty area which makes access to care challenging.

Medicare and Medicaid – two important programs for paying for health care for American Indian and Alaska Native (AI/AN) people. As we near the end of the COVID-19 Public Health Emergency (PHE), it’s going to be important to understand the differences between these programs and how they may impact reimbursements for telehealth services moving forward. Understanding these differences will be important for understanding the next steps for continuing to get reimbursed and any challenges that may be encountered in that process.

After a Veteran gets milk from the dairy aisle, and some bread from the bakery section, he stops at the ATLAS pod in Walmart and has a healthcare visit with his/her mental health, specialty, or medical provider.

In hopes of sparking renewed commitment to applying improvement science to telehealth, we offer this Telehealth QI and QA Miniseries. Today is the third in the series.

Recall that data can come in many forms and doesn’t have to be a report out of your electronic medical record (EHR). It can be hashmarks, start-end times, glass globs in a jar and more. I’m not kidding about glass globs. Once when I visited the Institute for Healthcare Improvement (IHI) there were two jars; one was labeled “Having a good day” the other was labeled “Having a bad day”. Each person who checked in at reception put a glob in the jar that reflected how their day was going.

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.

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.

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.