AUSTIN, Texas — The St. David’s Women’s Center of Texas is now at the cutting edge of reducing maternal mortality rates.

  • Hospital researching maternal mortality rates
  • 1 of 3 facilities in Texas to participate
  • First phase of trials targets premature birth

Reva Goujon became a patient there during her second pregnancy, when she was told she was at a high risk of developing a condition called placenta accreta.

“It was definitely deeply unsettling to know this risk was always looming,” Goujon said.

“Think of it as akin to the layers of an onion,” Dr. Jasbir Singh, Maternal Fetal Medicine Physician at St. David’s Women’s Center said. “After you deliver a baby you would expect the placenta to peel away from the wall of the uterus, if it’s grown into the wall of the uterus it attaches and it doesn’t detach.”

The condition can lead to excess bleeding, and can be life-threatening for the mother. Luckily, Dr. Haeri and Dr. Singh at St. David’s Women’s Center of Texas, are experts at treating it.

“It’s reassuring when the medical papers you’re reading also have the names of the doctors you’re seeing at the top because they were the specialists in this condition,” Goujon said. “In our first consultation with him, he looked me straight in the eye and said, ‘You are not going to die.’ And he repeated that with so much conviction every single meeting thereafter, and I’ve never had that level of confidence, or assurance from any other doctor. And his care his expertise, proved to be exceptional.” ​

“Reva is one of our favorites,” Singh said. “She was very scared, but that was also because she’s a really intelligent woman and knew what challenges lay ahead, and I think she felt comfortable because she knew that we had a well-oiled team that could handle her care, and that we were prepared.”

The St. David’s Women’s Center of Texas is now part of a national research network working to reduce maternal and fetal mortality rates. It is one of only three facilities in Texas to participate in the research done by the National Institute of Child Health and Human Development’s Maternal-Fetal Medicine Unit Network.

“It’s, in our specialty, considered the echelon of research. The top echelon,” Dr. Sina Haeri, Medical Director at the St. David’s Women’s Center said. “When you’re part of it, you’re basically at the forefront of perinatal medicine, doing research that truly impacts everyday disease.”

This week the Women’s Center at St. David’s began its first phase of trials, targeting a specific method of reducing premature birth. In the coming months they plan to roll out two more phases of trials, addressing hemorrhage and hypertension in mothers.

“It is heartwarming to see something you had a hand in change the practice of obstetrics across the world,” Haeri said. “It’s always good to be at the forefront of this so when your patients come in, every single intervention that might be available to them, is available to them.”

The research will benefit millions of mothers across the country, but St. David’s participation will directly impact mothers in Texas.

“If you go back to the whole maternal mortality morbidity issue that we talk about, one of the fundamental reasons behind the numbers being as high as they are is poor access to care, poor access to expertise,” Haeri said. “And we’re hoping to alleviate that.”

“The research component is critical, the funding to do that research is critical,” Goujon said. “So I think everyone can be reassured that that money is being well spent when you have experts who are really driven by their intellectual pursuit and finding answers and finding the best practices to deal with this condition, and Austin should be proud to have that here.”

Source: St. David’s Women’s Center Begins Maternal Health Research

“There’s just not enough mental health coverage across the state, but the rural areas are particularly hit hard,” said one doctor.

patient using telemedicine for doctor's visit

ID 137028483 © Piotr Adamowicz |

People living in rural areas face challenges that can take a toll on their mental health, including low wages, limited job opportunities and a lack of social capital. All of that is compounded by the fact that it can be harder to access mental health care in rural America.

From Months To Days

Now, telemedicine is helping to close the gap in treatments available in rural areas. At Meridian Health Services in Indiana, integrating telemedicine has reduced the wait time for new patient visits with a psychologist from months to days, according to NPR.

That makes a big difference for patient outcomes, said Meridian’s chief medical officer Dr. Sarfraz Khan.

“In my opinion, it’s lifesaving,” he said. Meridian was having trouble delivering mental health services because the organization couldn’t find doctors who were willing to work in rural areas.

“There was a time when we were seriously considering: Would it be viable for us to provide psychiatric services because nobody would like to come to small towns?” Khan said.

Now, doctors don’t need to come to small towns to work. They work out of a central location in Indianapolis. Patients, meanwhile, visit rural clinics for their appointments. There, a nurse takes their vitals and sets them up with a two-way computer screen, where they teleconference with a doctor from the city.

Patients Share Their Experiences

Some patients might balk at the idea of receiving health care through a screen, but a Meridian patient named Mariah said that telemedicine actually helps her be more honest with her providers.

“It’s easier because they’re not there, so I feel like I can tell more, and speak more and truly just be fully real. If they’re sitting right there, I might not want to say everything or say as much,” she said after finishing her first telemedicine appointment.

In Texas’s DeWitt County there are no practicing psychiatrists.

“We kept looking at what our needs were (in DeWitt County), and we did not have adequate access to mental health care,” Lynn Falcone, CEO of Cuero Health, told the Victoria Advocate.

Falcone knew that she was unlikely to be able to find a psychiatrist to come practice in the area, so she reached out to Access Physicians, a group that provides telemedicine services. Now, patients at Cuero Regional Hospital can have telemedicine appointments with psychiatrists.

Dr. Chris Gallagher, CEO of Access Physicians, said he is seeing more and more rural hospitals turning to telemedicine, especially for mental health services.

“Psychiatry is probably the most in-demand specialty,” he said. “There’s just not enough mental health coverage across the state, but the rural areas are particularly hit hard.”

Source: Telemedicine Closes Mental Health Treatment Gap For Rural Patients | The Fix

Frio Regional Hospital and Access Physicians are teaming up to keep cardiology patients closer to home in rural South Texas. The telemedicine group is providing specialty physicians to keep patients from traveling far to other facilities.

“There’s no reason that someone’s zip code should determine their access to the best clinical resources,” said Chris Gallagher, M.D., CEO, Access Physicians via release. “Pearsall residents rely on Frio Regional Hospital to be there for them, no matter their health care need or challenge. With our partnership, Frio Regional can keep that promise.”

On-site nurses and providers at Frio Regional will have consultation abilities with board-certified cardiologists via secure telemedicine technology throughout the day, providing more expertise than would regularly be available at the hospital, with the ability to treat arrhythmias, congestive heart failure, and more.

“Our mission is to improve the quality of life in our community by providing exceptional healthcare with compassion and respect,” said John Hughson, CEO, Frio Regional Hospital. “The telecardiology partnership with Access Physicians completely aligns with our mission … by bringing world-class cardiologists with compassionate bedside manner to our patients so they can stay close to home.”

Source: Access Physicians Bringing Telecardiology to South Texas – D Magazine

MEMPHIS, Tenn. (WMC) – Thirty-seven people in Shelby County have died from a suspected drug overdose-related death since the start of the year according to the Shelby County Health Department. Now Baptist MemorialHealth Care is using telemedicine to help tackle this growing epidemic.

The addiction specialists are brought in from the moment an addict asks a doctor for help. Telemedicine at Baptist Memorial Hospital now brings an addiction specialist that’s available 24/7 to meet with doctors and patients.

Focusing on Mid-South opioid crisis

“In addition to being able to save lives and stabilize we can also prevent further death and poor outcomes because we are able to treat these people acutely for their addiction and get the appropriate follow up medication and support,” said Dr. SDaniel Poor, ER Physician at Baptist Memorial Hospital.

The team effort to combat the growing opioid crisis started in September of 2019 when Integrated Addiction Care Associates partnered with the hospital to provide on-demand in-hospital consults, face to face with not only doctors but also the patient.

The overdose next door: How Shelby County is fighting the opioid crisis

The clinic’s approach is the first of its kind for West Tennessee. Bartlett based IAC tackles the road to sobriety for addicts through a three-step method caring for their patient’s physical, behavioral, and social needs.

The wrap-around care was the idea of Drs. Kathleen and David Stern after losing their son Alan in 2008 to an opioid overdose.

“It was very important to myself and my wife that we should really help other families so they wouldn’t have a lost similar to this,” said Dr. David Stern.

The Sterns opened the clinic last April and now see close to 400 patients.

Many of whom made the choice to change their life after a visit to the Baptist ER where the addiction specialists are called upon daily.

“I would like to think that it embraces them in kind of a way in a protective kind of cocoon so they can gain strength and then be able to renter which takes more skills to go back into the world where there are temptations and other things,” said Dr, Stern.

This program has since expanded from starting in Memphis. As of this month, it is now offered at Baptist’s Collierville and Tipton County locations with future plans to expand to Baptist Desoto.


Source: Memphis based hospital partners with addiction specialists to combat growing suspected drug overdose-related deaths

AMARILLO, Texas (KAMR/KCIT) — The entire nation is facing a physician shortage, according to projections from the American Association of Medical College. Dr. Brian Weis, the Chief Medical Officer at Northwest Texas Healthcare System, said the Texas Panhandle is no exception.

“If you look, a lot of the doctors coming out of training now, are heading to the major metroplexes. And so for a lot of these smaller regional facilities, they’re really struggling to recruit providers,” Dr. Weis said.

Data from the Texas Department of State Health Services shows nine out of the 26 counties in the panhandle have zero primary care doctors. When you increase that number to one primary care doctor or less, that expands to 12 counties.

Dr. Weis said telehealth is a growing solution to the problem.

“Some of our specialists, and subspecialists, provide services to those hospitals in a way that is accessible to patients in those communities, and they can stay in those communities,” Dr. Weis explained.

Dr. Shane Harper, Chief P.A. at the Texas Tech Department of Surgery said there are several ways to implement the technology into the medical field.

“Telecommunication can be something that’s over computer that’s at their desk or even now, even in their phones. For instance, telehealth could be where some insurance companies have it instead of going through your primary care physician, you can call a 1-800 number… and more or less have a facetime with someone to provide something simple, you know, cough and cold,” Dr. Harper explained.

From there, the technology has progressed to the point where specialists can see a patient for the first initial appointment, and then do all of the follow-ups via telehealth.

“If you live in Canadian, and you come and you see a specialist here, a cardiologist or whatnot…some type of follow up visits are just five-minute visits, ‘How are you doing, is your medication working?’ And really those are things that can be done as a face-to-face deal, over telehealth modality, versus coming all the way down to Amarillo, being here for five minutes, and then going all the way back to your home town,” Dr. Harper said.

The technology can also be used now for more serious injuries.

“We’ve brought it to the realm where we’ve done teletrauma, where someone is acutely injured in an outlying facility, if they’re set up with us, can go ahead and link up with us and we can see via very sophisticated FaceTime, that patient in real-time,” Dr. Harper explained.

Advancements in technology itself are not the only reason telehealth has progressed in recent years.

Dr. Weis explained, “There’s been some key changes in regulations at the federal level, that now allow for billing of these telehealth services.”

Rep. Four Price has been fighting for solutions to our rural healthcare problem for years. “I authored and passed some telemedicine legislation that broke down some significant barriers for providers to get paid by health insurance companies,” he said.

Rep. Price said the new technology brings hope to the panhandle. “Healthcare is an issue that’s always in the top two or three of what we deal with. It’s now one of the largest areas of our state’s expenditures and a very large $257 billion budget. So, I’m encouraged though, that we’ll find creative, efficient, and better ways to make healthcare more accessible.”

Looking forward, Dr. Harper said he hopes the technology can soon be implemented in ambulances, as they make a long trek with patients from surrounding communities and feed the data back to the E.R. in Amarillo before they even arrive.

Source: Telehealth offering a solution to primary care doctor shortage in Texas Panhandle | KAMR –

CLARION – Clarion Hospital, in conjunction with Penn State University, last week introduced a new program to aid in the treatment of victims of sexual assault.

The Sexual Assault Forensic Examination Telehealth Center (SAFE-T Center), established and maintained by Penn State University, is a telehealth program that enables rural hospitals in Pennsylvania to offer expert treatment in the aftermath of a sexual assault.

According to Clarion Hospital CEO Steven Davis, the local hospital is now one of six Pennsylvania hospitals that collaborate with the SAFE-T Center. Clarion’s involvement grew out of a need voiced by the District Attorney’s Office to ensure that perpetrators of sexual assault do not go unpunished due to “lack of evidence or lack of proper collection of evidence.”

“We are now bringing telemedicine technology to the Clarion community to make sure that, when we do unfortunately have these cases, we have all the resources and training in addition to access to a forensic nurse examiner remotely 24/7,” Davis said during last Wednesday’s program launch presentation at Clarion Hospital, noting that hospital personnel want to do what’s right for the victims through a holistic approach. “Our job is to make sure that we do the right thing and collect the evidence in a respectful, emotional way so that we meet their needs during that time of crisis.”

SAFE-T Center director Sheridan Miyamoto reported that the program is a response to a documented lack of professional staff specifically trained to deal with victims of sexual assault.

“[Often] someone without any training in the ER is kind of tapped to do that exam,” she said. “They’re opening an evidence collection kit and reading instructions in front of a patient on arguably one of the worst days of their lives.”

In addition to having instant, on-screen access to an expert nurse during the examination and interview, the program will also train on-site nurses to be available for assault victims in their time of need.

SAFE-T Center clinical nurse coordinator Faith Mong joined the Feb. 12 discussion remotely to demonstrate how the secure and encrypted technology operates. Not only does it allow for interaction between the nurse on site and the SAFE-T nurse, but it also enables the SAFE-T nurse to assess and interact with the patient firsthand.

“What’s really great about this system is that someone like me can be in a secure location and not have to travel to the hospital, which reduces the amount of time the patients have to wait for care, at least on our side,” Mong said.

In honor of National Love Your Pet Day on Thursday, Feb. 20, readers of The Leader-Vindicator and Jeffersonian Democrat recently submitted photos of their pets. The photos are featured on special Love Your Pet Day pages in this week’s edition of both newspapers.

She also reported that while a few patients have declined to have the remote technology available during their examination, most have been welcoming and appreciative of the service.

“I truly perceive that the patient feels like I’m in the room with them by the end of their care,” Mong added, noting that some patients have even attempted to hug the monitor during their visit. “I think that if you have the right person on this side, it can very much feel like we’re just another person making sure they get the quality of care they deserve.”

Six nurses at Clarion Hospital will be a part of the Sexual Assault Nurse Examiner (SANE) program, Miyamoto noted, indicating that they have completed and are participating in ongoing training in all aspects of patient care and support. This involves more than 40 hours of training, two full-days at Penn State doing hands-on training with live models and additional training on the equipment.

“This is really difficult work to do, and it’s wonderful to see that you have nurses here that are raising their hands to be trained and really be a quality response in the community,” she said, adding that there only 53 SANE-trained nurses across the state. “They have put in a tremendous amount of effort.”

Funding for the SAFE-T Center has come from a variety of sources, according to officials. It began with money from the Department of Justice Office for Victims of Crime and the Pennsylvania Commission on Crime and Delinquency. Locally, a contribution was made from the Fraternal Order of the Eagles to help offset the costs of starting and sustaining the program.

“This grant has paid for the equipment and a tremendous amount of training, but there’s still a cost,” Davis said, noting that sometimes rural hospitals provide services to the community simply because the service is necessary. “Sometimes you do things for the right reason. You may not make money doing it, it may cost you money to do it, but it’s the right thing to do.”

Ending the presentation, PASSAGES Inc. executive director Marlene Austin added her enthusiastic support for the local implementation of the SAFE-T Center.

“We can now be sure that all sexual assault survivors are in the best hands. They’re going to be shown compassion, and most importantly that they are going to be believed,” Austin said of the Clarion Hospital program. “So on behalf our staff, we would like to thank you all again for all of the collaborative efforts. I’m thrilled that it’s going to be a part of Clarion.”

In addition to hospital, SAFE-T Center and PASSAGES representatives, several local law enforcement officials, as well as state Rep. Donna Oberlander and Sen. Scott Hutchinson attended last Wednesday’s program launch presentation.

According to Allina Health, virtual visits tripled from 2018 to 2019. It’s used for everything from family practice to psychology to infectious disease.
Telemedicine is growing, but is it for you?
Volume 90%

You’re sick. You don’t have time to go to the doctor, or maybe you don’t feel like going to the doctor. Now there’s an app for that.

Actually, there are plenty of apps and websites for that. Telemedicine is a growing field. One study found a whopping 82% of millennials would rather use telemedicine than see a doctor in person. According to Allina Health, virtual visits tripled from 2018 to 2019. It’s used for everything from family practice to psychology to infectious disease

But perhaps you’re skeptical. I mean, how can you get treated for a sinus infection without seeing a doctor? Well, in some applications of telemedicine, you can see the doc through video chat. In other cases, it’s simply an online visit, and yes, even in those cases, you can get a prescription. How is that possible?

RELATED: Walgreens to shutter in-store clinics, add Jenny Craig sites

RELATED: Sam’s Club launches health care pilot to members

You fill out a fairly impressive questionnaire about your symptoms and your medical history. You can send in photos if it’s something like a rash or skin condition and you may get a call from a nurse practitioner if they need more information. Think of it like this – it’s more like a minute clinic versus an emergency room.

“I went on my phone and I thought, I’ve never tried anything like this,” says Lauren Twomey.

Lauren was in a pinch. It was the night before a vacation and she didn’t have time for an appointment.

She tried Virtuwell.

“I was called by a nurse practitioner and she said, yep, we can get you treated for that and within a couple of hours had picked up my prescription and was ready to go on my vacation,” says Twomey.

RELATED: HSA, FSA, HRA: What’s the difference?

RELATED: ER, urgent care, doctor’s office: Breaking down the costs

Virtuwell started 10 years ago and treated about 30 different conditions. Now, they treat well over 60 conditions and have helped more than 500,000 patients. From allergies to ear infections and bladder bothers to pink eye. They take all major insurance, but even without insurance, the bill is never more than $49. Much cheaper than an in-office visit.

“Think of the number of times you’ve called your clinic to ask a question about this new symptom, or maybe I got a reaction to this new medication, so what we offer is free follow-up care for that visit, so we really think you’re paying $49 to get treated for this condition,” says Kris Johnson, Sr. Director of Product Development for Virtuwell.

And they’re not the only option. Teladoc has a similar product and offers a video option if you’d like to see someone, quote unquote, face-to-face. United Healthcare and Allina Health have telemedicine offerings too. All of them about $50 to keep competitive. Some companies even offer the service to their employees for free. Telemedicine is not only saving time and money, it’s saving lives.

RELATED: Kaiser: How far telemedicine has come

RELATED: Telemedicine goes more mainstream, but cost remains obstacle

“Time is of the essence in the treatment of stroke. Every 15 minutes in delay is a potential 5% increase in mortality,” says Dr. Justin Patee, Regina Hospital emergency physician.

Telestroke is crucial in places like Regina Hospital in Hastings. With no neurologist on staff, it connects patient with expert quickly to make sure treatment is fast.

“There’s risk attached to the treatment, the diagnosis can be difficult and the treatment paradigm is complex, so doctors at rural sites really need assistance in the process,” says Dr. Sandra Hanson, Allina Health Telestroke Medical Director.

Dr. Hanson and other neurologists are on call for rural hospitals, or even big city hospitals, that need a doc fast, like in the middle of the night. And even with something as serious as stroke, the video connection works.

“This might surprise you, but there are some cases where using the magna view with the camera, I get a better view of things like eye movement, and pupillary reaction to light, and things like that, than I would get if I was using my own eyes bedside,” says Dr. Hanson.

We’ve really only touched the surface of what telemedicine does now, and where it will go next, is changing daily. For now though, trust that you can have that rash treated, you can have that cough cleared up, by a true medical professional, without leaving your house or your job.

Source: Telemedicine is growing, but is it for you? |

Across the country, there is a shortage of mental health workers.

In Nebraska, most rural communities have no access to psychiatric care.

“Eighty-some of the 93 counties in Nebraska have no access to mental health care for pediatric patients,” says Dr. Jennifer McWilliams.

She is the division chief of psychiatry at Children’s Hospital and Medical Center.

She says families out in rural communities often forgo the care they need because they don’t want to drive hours to get to Omaha or Lincoln to see a doctor or counselor.

McWilliams has a camera mounted to her office computer.

Through a protected app, she is able to log on and connect to her patient, who is sitting at a computer, in another town.

Barbara Trollope’s son is being treated for ADHD.

She lives in Albion, Nebraska.

She says that if it weren’t for telemedicine, she would have to take off work and pull her son out of school to take the day trip to and from Omaha to see McWilliams.

“I see how much it has benefited my son being able to talk to her and stuff like that, I think its great,” says Trollope.

McWilliams says other fields of medicine are starting to treat patients through telemedicine, too.

“The equipment has evolved exponentially,” McWilliams says. “You can have a stethoscope plugged in on one side of the computer that a nurse is using on the other side that a doctor can hear heart sounds, lung sounds, and belly sounds.”

According to data provided by Children’s Hospital and Medical Center, the growth in these virtual visits has doubled in two years.

There were about 1,200 patient visits in 2017 –and 2,300 visits in 2019.

“For some kids, they have significant trauma histories or anxiety, it really is more comfortable to have distance, and safety of the screen,” says McWilliams.

“I love being able to improve mental health care in corners of my state where there wouldn’t have been health care before.”

Dr. McWilliams says federal prescribing laws require patients to log onto a computer at a medical facility in order to have medication prescribed to them over the computer. But other visits can be done from their home.

McWilliams adds that most private insurance companies cover telemedicine the same as they do other office visits.

Source: Telemedicine visits nearly double at Children’s Hospital and Medical Center

WATERLOO, Iowa (KWWL) – UnityPoint Health – Allen Hospital is expanding its use of telemedicine, which allows physicians in different parts of the country to video conference a patient for care.

Starting Feb. 25, Allen is adding six telehospitalists to its team. The board-certified physicians will provide general inpatient care for patients in different wings of the hospital from 7 p.m. to 7 a.m.

The telehospitalists work for a company called Eagle Telemedicine. They’re caring for patients in Waterloo, but they’re stationed in other states.

“There’s [a telehospitalist] in Oklahoma, some in Florida, one in North Carolina and one in South Carolina,” hospitalist medical director Dr. Pradeep Ramesh said.

With a special cart equipped with diagnostic tools, telehospitalists act as bedside physicians. They can communicate with their patients, who are admitted into Allen, using a videoconferencing monitor and high-definition camera.

“I can pan, I can zoom, I can see everyone in the room,” Dr. Ramesh said. “There’s really no limits to what we can do.”

The six remote physicians will work closely with on-site care teams at Allen.

Nurses will help telehospitalists conduct full physical and neurological examinations, and with special equipment, they can also listen to a patient’s heartbeat and breathing.

“Just like I have an actual stethoscope… the nurse has a Bluetooth stethoscope there and when she puts it on the patient’s chest, I can hear the heart sounds as well, if not better, than the stethoscope that I normally use,” Dr. Ramesh explained.

While some may be skeptical about telemedicine, one patient who tried the technology on Monday said he was pleased with his care.

“I don’t find a problem with it whatsoever,” Jim Reynolds said. “I’d do it again in a heartbeat.”

Working only during overnight hours, the remote physicians will help fill staffing gaps in the hospital, allowing patients to get faster personal care. Before the new program, patients may have waited for on-call doctors to travel to Allen.

“When we have these large volume of patients and we have a lot going on in different floors, this is now allowing this doctor, they’re not walking from point A to point B,” registered nurse Taylor Harrell said. “You bring in the camera and [the telehospitalists] beam in.”

The hospital is staffing physicians all day, and physician specialists will be on-call for emergency situations.

UnityPoint Health is also using telehospitalists in Fort Dodge and Marshalltown.

WATERLOO, Iowa (KWWL) – UnityPoint Health – Allen Hospital is expanding its use of telemedicine, which allows physicians in different parts of the country to video conference a patient for care. Starting Feb. 25, Allen is adding six telehospitalists to its team. The board-certified physicians will provide general inpatient care for patients in different wings of the hospital from 7 p.m. to 7 a.m. The telehospitalists work for a company called Eagle Telemedicine. They’re caring for patients in Waterloo, bu

Source: TELEMEDICINE TECHNOLOGY: Allen Hospital adding six remote physicians to its hospitalist team

Nevada ranks as the seventh-largest state in terms of land size. With many rural communities around Reno seeking access to specialty physicians, it can be challenging for doctors to regularly visit small towns like Elko, Tonopah, Winnemucca and Fallon to provide patients with the medical care they need.

As technology continues to change, many health care companies like Renown Health have incorporated telemedicine offered to better meet the needs of those in rural areas who otherwise would have challenges seeing a doctor for certain conditions due to their geographic location.

According to Mitchell Fong, Director of TeleHealth at Renown, telemedicine comes in multiple forms, depending on the patient’s location and medical needs. When Renown launched its TeleHealth program in 2012, it was designed as a small pilot project to provide rural populations with access to remote specialty care using advanced technology such as Bluetooth stethoscopes, high-definition peripheral cameras and enhanced broadband connectivity.

In the past, specialty physicians would have to make trips out to small towns throughout the state maybe once or twice a month to provide care, or patients would struggle to find transportation or the means to travel hours into a city to see a doctor at a large hospital, according to Fong.

“Patients tell us that they wouldn’t even get care for some of these specialties if they had to drive all the way in [to Reno],” Fong said. “Ultimately, I hope that we’re improving the lives of these patients by allowing them to live their best life and not waiting until they have a severe episode.”

Many general practitioners working in rural areas also experience isolation and burnout being the only doctor in town, which leads to high physician turnover and doctor shortages across remote areas. Now that rural doctors have the opportunity to interact and engage with specialty physicians and other health care providers via telemedicine, it has provided a greater sense of community and lower levels of isolation and burnout in rural doctors, according to Fong.

In 2019, Renown’s TeleHealth program logged over 5,500 telemedicine visits. Fong said the focus is now on how telemedicine can create an impact for those still underserved in urban communities, too.

Urban expansion

One of the biggest challenges companies like Renown face when it comes to expanding telemedicine into the urban setting are the rules and regulations of reimbursing the cost of services. According to Fong, specific services were only approved to be reimbursed if they were done in rural locations. Programs like Medicare are eliminating these limitations, which will allow patients in urban settings to use telemedicine services as well.

Fong said when it comes to services Renown will offer to urban patients, it will be a direct-to-consumer method of care such as video chatting with a doctor on a smartphone. Of course, there are limitations. Patients don’t have the proper equipment such as high-definition cameras or stethoscopes at home, but there are many specific uses the direct-to-consumer method is good for.

“It’s really thought of as a lower acuity urgent care setting,” said Fong. “Some of the most common conditions that we treat in that virtual setting are sinusitis, respiratory infection, urinary tract infection and flu symptoms.”

Minor skin lesions can also be examined over video chat, but Fong said those are the top four most common virtual visits the direct-to-consumer method should be used for.

Still, patients might be unsure if their maladies are fit for a virtual visit or a trip to the hospital. Fong said TeleHealth’s online platform prompts patients to answer a series of triage questions about the length and severity of their condition before directing them to make a decision on where to go.

“Some triage questions have a built-in algorithm, so as you’re answering these questions based on your condition, your severity your exposure, it can actually stop the questions and say, ’Your condition sounds like you should be going to the urgent care,’ or ’Your condition sounds like you should be going to emergency care,’” Fong said. “That way, instead of going through the entire questionnaire, getting your virtual visit and then being redirected, it’s redirecting you upstream.”

Medical misconceptions

According to Fong, a common misconception about telemedicine is that it’s difficult for patients to develop a relationship with their health care provider. Fong said many patients have stated in recent surveys that they prefer communication with their doctor through telemedicine over a traditional face-to-face visit. Patients expressed their in-person experiences wherein their doctor spent much of their time sitting behind a computer documenting information. Those who’ve used telemedicine experienced more interaction from their doctor despite the conversation taking place over video.

Another common misconception is that the level of care in telemedicine isn’t as high as it would be in a regular doctor’s office. Although the direct-to-consumer method of video chat has its limitations, in-clinic visits come equipped with HIPAA compliant technology such as advanced cameras and stethoscopes that allow doctors to examine the eyes, nose, ears and throat as well as listen to the patient’s heart and lungs as if they were in the exam room with them.

“At the end of the day we ask our providers to ensure that the service we’re delivering is at least the same level of quality as they would be delivering face-to-face, and that is the expectation that we hold across our TeleHealth program,” said Fong.

When Fong joined Renown’s TeleHealth department in 2012, Nevada was ranked as the 47th worst state for access to health care providers. According to Fong, the future of telemedicine in the state is leveraging these innovative technologies in a more efficient fashion in order to better serve both rural and urban populations.

Source: Reno News & Review – House call – Family Guide – Guides – February 20, 2020