Is telehealth finally here for rural areas?

By Marnie Werner, Vice President, Research & Operations

Telehealth has been a long time coming. Telehealth is technology that allows people to access health care services over long distances. We’ve seen it in movies almost since movies began and on futuristic TV shows like Star Trek. It was pioneered in the late 1900s, with stories about robots performing surgery, guided by doctors in faraway places and other such hugely complex uses.

It’s only with the coming of the internet, though, that we’re really able to say telehealth is here, it’s practical, and that its ability to fulfill its promise for rural areas is real.

Telehealth is simply health professionals offering health care over a distance using some form of communication technology. Until now, it has been largely over the phone, as a recent article in the New Ulm Journal explained: “‘Historically, in situations like this (a neonatal birth), the team in New Ulm would have gotten on the phone and talked with our neonatal nurse practitioners and our neonatologists in the Twin Cities…’” Judy Wenzel told the New Ulm paper. Judy is the director of telehealth at Children’s Minnesota Hospital, a large specialty hospital in the metro area.

In New Ulm recently, nurses were practicing for a neonatal emergency—a simulated premature baby with breathing difficulties—using a mannequin. The procedure was being overseen by the specialists at Children’s Hospital via a special “virtual care cart” that comes equipped with a video screen, a camera and microphone and internet connection. Rather than trying to describe the patient’s condition over the phone, nurses and technicians can use the care cart’s built-in technology to transmit a large amount of a patient’s health data to medical specialists at the other end, usually in a large urban hospital or research center. Even better, the specialists and patients can see and talk to each other.

Telehealth will be a genuine game-changer for rural areas, which have struggled for decades now to offer advanced health care to patients. Specialists are absolutely necessary, especially for the elderly, infants and children, and patients going through big all-encompassing health issues like cancer. However, given the shortage of health care professionals right now, from technicians to nurses to doctors and surgeons, competition is stiff. Rural hospitals and clinics, which see fewer patients, can have a difficult time affording many if any specialists. The same goes for mental health care, another area that telehealth is well suited for.

As a result, specialists tend to be found only in facilities in larger population centers. That means for patients who live farther out, a one-hour visit to the specialist can involve a two- or three-hour trip each way, basically eating up an entire day, and the travel can be hard on the patient’s health. Finding drivers with the time or inclination to take a patient that distance is becoming increasingly difficult as well. At the same time, if the specialist much travel to see patients at a remote hospital, say, once a week or once a month, his or her ability to meet with patients and spend real quality time with them is extremely limited.

Telehealth offers rural health care facilities the ability to connect patients with specialists without that level of travel for either side. The specialists can stay where they are, while the patient can visit his or her local clinic—perhaps a ten- or twenty-minute ride instead of an all-day ordeal. It should also greatly improve the flexibility in scheduling. A patient wouldn’t need to choose between spending a day traveling or waiting weeks to see the doctor, and the doctor gets to spend more time with each patient.

At the clinic, a nurse operates the care cart and acts as the go-between, helping with communication. “(T)eleheath resources such as the virtual care cart increase communication and can allow for quick consultation between providers and patients,” Karen Mathias, director of the simulation program at Children’s, said in the New Ulm Journal article. And then, as part of the consultations, the specialist can decide whether the patient should be transported to a larger facility for more advanced care.

There are still issues, including whether health care providers get paid the same amount for an online visit as they would for an in-person visit. Minnesota requires this “parity,” that both types of visits be treated equally and paid equally, but Medicare does not. That’s an issue in rural Minnesota, where a large part of the population is older and their health care is covered by Medicare.

But still, the potential for telehealth is huge, with rural patients perhaps being the biggest winners, but it still all depends on good broadband internet access. As more communities throughout Minnesota get connected, more health care facilities and the people they serve will see the benefits.

Thanks to the Blandin on Broadband blog for bringing the New Ulm article to our attention.