Patients

I don’t think I need to say why everyone was more than ready to say goodbye to 2020. Even New Year’s Eve was probably the most subdued we’ve ever had. It was sad to watch the ball drop in NYC without a soul in site, but we stayed up anyway by watching old Abbot and Costello skits from the Colgate Hour – amazing what you can find these days and it’s hard not to laugh at “Who’s on First” no matter how many times they do it. What’s to look forward to in 2021? Infinite possibilities! New Year’s offers the opportunity to envision all sorts of new and exciting things ahead and to reset the course of our lives and events. I have high expectations for 2021, saying goodbye to the trials of yesterday while holding firmly to the triumphs and lessons learned last year. The road ahead is wide open and our gas tanks are full – drive on everyone to new adventures!

The Southwest Telehealth Resource Center (SWTRC) and the Arizona Telemedicine Program (ATP) had the pleasure of working with the United Way of Weld County, CO to provide a webinar to their membership on November 6, 2020. “Effectively Engaging Families in Telehealth” was a very informative and addressed one of the most asked questions about telehealth, how does a provider build an intrapersonal relationship through a screen? Janet Major, Associate Director for Education & Facilities for SWTRC/ATP and Dr. Elizabeth Krupinski, Co-Director, STWRC addressed this question with the central message being that physicians and their support staff need to prepare for each telehealth visit. If a provider is prepared, the visit should go smoothly and an intrapersonal relationship can be established just like an in person visit.

We pause each November to give thanks. This year, more than ever, it is important to give thanks. For many of us, we are thankful that everyone now knows what telemedicine is and are actively using it even though many of us have been supporting telemedicine and telehealth for well over 20 years. We asked a few friends and colleagues in the Southwest region “What are you thankful for?” and below are their responses. We hope that you too will be thankful. “I am extraordinarily thankful, now more than ever, for both my health and my financial stability. I am also thankful that there has been a burning platform for, and therefore a tremendously increased use of telehealth processes, by both clinicians and consumers. Finally, I am thankful to be able to significantly increase my contribution to the improvement of the US healthcare system as a result of the increased interest in telehealth processes.”

COVID-19 has overstayed it welcome for most of us. Everyone’s lives, across the nation and world, have changed drastically in the last nine months. While COVID-19 has impacted everyone, everyone’s experiences have been different. This summer, I had the privilege to speak to Carol Lewis about Yavapai county, Arizona’s experience and how rural centers are handing the pandemic. But even rural centers experience the effects of the pandemic differently from each other. To explore different experiences across the southwest, I reached out to The Wayne Community Health Center in the rural town of Bicknell, Utah. Bicknell is one of the 10 communities that make up Wayne County. Wayne county contains about 2,475 square miles (105 miles long and 23 miles wide) in south central Utah, 97% of which is federal and state land. The population of Wayne county is about 2700 and there is only one medical doctor in the county to serve them. Of 2700 people in Wayne county approximately 81% of them have health insurance. The demographic of the population is mostly Caucasian (91%), with the median age and income being 41 years and $45K respectively.

I don’t use a smartphone to access Telehealth. Being a “tetraplegic” I have no use of my hands, so I invented a unique way to operate different electronic devices.
I created two styles of mouth sticks.
This one I use while in bed. It’s made from a quarter inch wooden dowel with both ends covered with surgical tubing. If you notice, one end is covered two and a half inches and the other a half inch. The longer end is for biting on and the other is to cushion the tip.
The second mouth stick I use while sitting up in my wheelchair. I can drive up to the desk I designed and park myself in front of my keyboard and computer. The mouth sticks I use while in my chair has a lucite bite impression the dentists made for me. I don’t use this type of mouth stick while laying down in bed because I can’t easily swivel the stick from side to side.

The coronavirus pandemic has changed our lives in many ways. Adapting to the “new normal” can be difficult, I know. However, now we have enough technological solutions to continue many of our regular activities. For instance, we’re getting used to working from home and ordering takeout. I stay in touch with my friends and relatives thanks to video calls, and I even purchased weights to work out at home. Is there anything we can’t do from home? For instance, what can you do if you or your child feel sick?

I have spent the last year training as an infectious diseases pharmacist at Banner University Medical Center-Tucson. A large part of this has been participating in weekly HIV office visits at the Petersen HIV Clinics with Stephen Klotz, MD, Larry York, PharmD, and our lead clinical coordinator, Cesar Egurrola. This multidisciplinary team approach allows the physician to guide the patient’s care, the HIV clinical pharmacist to manage the medication aspects, and the clinical coordinator to manage the behavioral and social needs.

There is no doubt that COVID-19 has disrupted our healthcare systems and the general population worldwide in a host of ways no one could have imagined just 6 months ago. On a regular basis, we hear on the news stories about how many cases there are, how many deaths, where to get tested, hot spots, how healthcare disparities contribute to certain populations being more vulnerable than others, and how we need to social distance, wash our hands and wear masks.

COVID-19 and stay at home orders forced many practices, hospitals, urgent care, and clinics to turn their operations upside down overnight. Patients were canceling appointments left and right due to "the fear of the waiting room". Many primary care providers were seeing upwards of 80% cancellations.

Last month, Psych Associates (Springfield, MO), where I practice, went to an “online office,” which meant every provider in our practice set up a virtual therapy room in their home. We’re all trained up on Telehealth, so ready, here we go! I’m a newbie to the world of virtual therapy so I really didn’t know what to expect, but I’m brave in my work, so I trusted that everything would work out fine. The threat of coming in contact with the deadly coronavirus Covid-19 was real, and of course we all wanted to stay well, and keep our clients well, so we acted quickly. Luckily, it was a smooth transition.