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Tipping telemedicine barriers

During the fall of 2011, I was selected to participate in the civic leader fellowship program put on by the Flinn-Brown Foundation. Not having aspirations for political office, I channeled my knowledge of healthcare with my passion for telehealth and jumped in headlong to fulfill the requirements of the program.

Each graduating fellow was charged with the responsibility to develop a common good project that served the citizens of Arizona. Each graduate was also assigned a mentor to help us on our journey. My mentor, Bob Smoldt, is the Chief Administrative Officer Emeritus for Mayo Clinic, Director of the ASU Healthcare Delivery and Policy Program and a great guy.

During initial meeting, I pitched Bob on different ideas that would improve healthcare delivery using telehealth technology. We reviewed existing barriers and quickly realized that to have the biggest impact, we needed a louder single-voice and some additional support. Bob solicited the help of Deni Cortese, Chief Executive Officer and President of Mayo Clinic, and Natalie Landman, PhD Associate Director for Projects at the ASU Healthcare Delivery and Policy Program (HCDPP).

Collectively, we decided to produce a barrier mitigation telemedicine white paper.

eICU telemedicine nurse and patient

An ICU nurse at North Colorado Medical Center in Greeley checked in on one of her patients. He was on a ventilator and his vital signs all looked fine. But the nurse had a feeling something was wrong. She contacted the Banner doctor who also was monitoring the patient from more than 800 miles away.

Telemedicine and Behavioral Health

Teri Dunn, a licensed clinical social worker, has been working with behavioral health patients for 34 years. For the last 12, she’s been with North Country HealthCare, a community health center based in Flagstaff.

North Country also serves patients at 14 other sites across northern Arizona, where there used to be little or no access to behavioral health care.

Telemedicine has changed that. 

telestroke computer

Jack Porter isn’t one to admit he had a stroke three years ago.

“I didn’t have a stroke,” he will tell you. “I had a stroke of luck.”

Porter, who has lived in Bisbee since he was two weeks old, was unable to talk or move his left leg or left arm when he arrived at Copper Queen Community Hospital’s emergency room. Daniel Roe, MD, chief medical officer and director of emergency services and telemedicine at Copper Queen, ordered a CT scan that showed a clot forming on the right side of Porter’s brain.

But there was no neurologist at the hospital to advise what to do next. And that’s what led to Porter’s “stroke of luck.”

Telemedicine and a POT (plain old telephone)

"In terms of disease management,” stated Dr. Devi Shetty in Sanjit Bagchi’s article Telemedicine in Rural India, “there is [a] 99% possibility that the person who is unwell does not require [an] operation. If you don't operate you don't need to touch the patient. And if you don't need to touch the patient, you don't need to be there. You can be anywhere, since the decision on healthcare management is based on history and interpretation of images and chemistry...so technically speaking, 99% of health-care problems can be managed by the doctors staying at a remote place—linked by telemedicine.”

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