How Telemedicine is Changing Rural Health Care
Telemedicine is today making specialized medical care available to more patients in rural areas of the United States and elsewhere around the world. Health care consumers in these rural areas have traditionally been underserved in terms of overall medical care. They also have virtually no access to specialists for urgent medical issues, apart from transport to a big-city hospital for care, which is both expensive and time-consuming.
Those seeking an example of telemedicine’s transformative powers need look no further than the state of Mississippi. The Magnolia State has long ranked at or near the bottom of the 50 states in terms of the quality of health care available to its citizens.
‘A Sickly Reputation’
In an early 2015 posting at Politico.com, Dave Pittman, Politico Pro’s eHealth reporter, points out that Mississippi “has a sickly reputation.” He goes on to recite a litany of the state’s rock-bottom health rankings: “worst infant mortality and most kids born with low birth weight; second-to-highest rate of obesity and cancer deaths; second from the last in diabetes outcomes.”
Helping to turn things around in Mississippi, reports Pittman, is telemedicine, one area in which the state has made great strides, surpassing a number of other states. He notes that the state’s only academic hospital — the University of Mississippi Medical Center in Jackson — has remote connections with more than 160 sites in virtually every corner of the state. These remote connections allow the delivery of specialized medical services to patients in remote areas of the state that have been traditionally “medically deprived.”
In the Forefront of Telemedicine
As a result of such advances on the digital health front, Mississippi in early 2015 was ranked by the American Telemedicine Association among the seven states with the best telemedicine programs in the country, according to Pittman. This is a significant achievement for a state with the worst doctor shortage in the country. Massachusetts has roughly 2.5 times as many doctors per capita, and the ratio increases to 3-to-1 when it comes to specialists.
Mississippi is not alone, of course, in making significant advances in delivering urgently needed medical care to rural areas of its state. In late September 2015, WPSD-TV in Paducah, Kentucky, reported on how a telemedicine program in nearby southern Illinois is giving patients in rural Harrisburg, Illinois, about 55 miles north of Paducah, access to the world’s top specialists.
Specialists Hard to Recruit
Rodney D. Smith, president and chief executive officer of Harrisburg Medical Center, told WPSD that the small medical center has always had a hard time recruiting full-time medical specialists. As a result, until recently, contact with medical specialists was usually limited to telephone conversations between local doctors and specialists at distant medical centers. Local doctors could only describe the symptoms and conditions of Harrisburg patients about whom they needed the input of medical specialists.
Now, thanks to a grant from the U.S. Department of Agriculture, rural doctors can use telemedicine to access the consultative services of the area’s top medical specialists. Robert Hodson, D.O., a local Harrisburg physician, told WPSD, “We [he and the specialist] can do an exam together in real time, and I think the patients enjoy it because they feel like we are really on the ball. We’ve got access to a neurointensivist, and we’re really trying to get their care expedited.”
Robotic Devices Used
For the new telemedicine-enabled consultations with specialists, a robotic device is wheeled into place beside the patient being treated. Over an Internet connection, the distant specialist can closely examine the patient, diagnose his or her problems, and prescribe an appropriate course of treatment.
Smith points out that the telemedicine robots have cameras attached that can zoom in on any area of the patient’s body to enable close examination. So powerful are the zoom features on these robot cameras that specialists can see parts of the body “better than with the naked eye,” he said.
As of September 2015, the Southern Illinois Telemedicine Network, which serves Harrisburg and other rural locations in the region, is used only for mental health patients and stroke care. However, the network hopes soon to expand to include remote consultations for cardiac and trauma patients as well.
New Mexico’s Project ECHO
A similar project in New Mexico is bringing specialized pediatric care to children with chronic diseases in the state’s rural areas. Known as Project ECHO (Extension for Community Healthcare Outcomes), the program was developed at the University of New Mexico Health Sciences Center, according to an article at DailyLobo.com.
Under ECHO, primary health care providers in rural and medically underserved areas of the state can utilize teleconferencing equipment to discuss a young patient’s clinical care with specialists in large urban medical centers. The pediatric care telemedicine program is being developed in a partnership between ECHO and the American Academy of Pediatrics. While its immediate focus is on care for pediatric patients in New Mexico’s rural areas, it is hoped that the program can gradually be expanded to serve a billion or more patients worldwide.
‘A Powerful Tool’
One area in which ECHO hopes to provide specialized care is in the treatment of rural pediatric patients with epilepsy. Sucheta M. Joshi, M.D., a pediatric neurologist who helped to developed ECHO’s program for epilepsy treatment, told DailyLobo.com that the program “can be a powerful tool to educate and enable physicians to care for children with challenging medical issues. . . .”
In Minnesota, telemedicine is helping to bridge the gap between a rising demand for mental health services and a growing shortage of psychiatric specialists, particularly in the northern part of the state. A recent article in the Duluth News Tribune looked at Duluth-based psychiatrist David Baldes, M.D., and his participation in a telemedicine program that brings specialized care to patients in rural areas of the nearby Iron Range.
Dr. Baldes has been based at Duluth’s St. Luke’s Mental Health Clinic for roughly two years, and for almost all of that time, he’s been providing telepsychiatric services to patients in Hibbing and Iron Mountain, towns that are roughly 90 minutes from Duluth by car. Telemedicine and psychiatry are an exceptionally good fit, says Dr. Baldes, “because we don’t lay on hands. Our examination is observational and conversational, so we’re well-suited for this kind of service.”
The shortage of psychiatric specialists is not limited to northern Minnesota but is a problem throughout much of the country. A 2014 study from the Henry J. Kaiser Family Foundation found that the United States has only about half the number of mental health professionals necessary to meet current demand for mental health services.
Don Amerman is a freelance author who writes extensively about a wide array of nutrition and health-related topics.