The patient-provider relationship is a sacred bond that has existed since the dawn of healthcare. The trust and responsibility placed on the provider by the patient to heal and act with their best interest in mind remains at the core of this relationship even in the modern age of healthcare.
Rural healthcare is suffering, but many communities have yet to swallow the medicine that could make a difference: telemedicine.
Several vectors have led to what the National Rural Health Association estimates is more than 50 rural hospital closures over the past five years, with 12 already closing in 2016 so far. The challenges that rural healthcare face include a high percentage of uninsured and elderly patients, reduced populations, equipment that is not fully utilized, and the lack of lucrative specialty services that help support hospitals financially. There also are the issues of getting patients to rural hospitals in a timely manner due to travel distances, and luring top talent from larger cities.
Telemedicine can address many of these issues if rural communities take the opportunity seriously.
We all know telemedicine works, that patients and providers like it, and that outcomes are increasingly being shown to be positive on a wide variety of measures. There are also lots of studies looking at patient groups and assessing whether they would accept and use telemedicine services. Most of these however are focused on a dedicated group of patients (e.g., the elderly, those with COPD) and don’t really capture the bigger picture.
In Early September we had the pleasure and honor of conducting a telemedicine training event as a pre-session course before the Congreso de Telesalud Región de las Américas 2014 that was held in Nuevo Leon, Mexico. Dr. Pedro Ramos extended the invitation to us and he and his associates welcomed us with open arms and made our visit quite enjoyable. Four representatives of the Arizona Telemedicine Program (ATP) and Southwest Telehealth Resource Center (SWTRC) traveled to Monterrey, Nuevo León, Mexico to train a group of healthcare providers, share information and ideas, and learn about telemedicine programs in our neighboring country.
Tooth decay remains one of the most common chronic diseases of childhood especially for Arizona children. Many Arizona Children start school with tooth decay, a disease that is largely preventable. Early tooth decay can start in children as soon as the first teeth erupt and progresses with age. By the time Arizona children reach 3rd grade, over 75% of them have experienced tooth decay. Arizona’s oral health workforce is challenged by the high dental needs of the state’s children, especially in rural areas which extend into 80% of the state’s land.
Telemedicine is slowly making progress in terms of more and more CPT codes for reimbursement being approved each cycle. For CY 2014 there are 2 new codes that have been added to the list of Medicare telehealth services! The first one is CPT code 99495 for Transitional Care Management Services.
There are so many applications for telepsychiatry it is often hard to keep up with all of them!