The Arizona Telemedicine Program Blog

There is a glaring shortage of healthcare providers across the world as is, and with the novel coronavirus epidemic taking over the world, hospitals are stretched too thin. It is envisaged by Inside Higher Ed that there will be a shortage of almost 120,000 doctors in the United States alone by the year 2030. The extremely lopsided doctor to patient ratio in some clinical specialties and geographic locations highlights the difficulty healthcare providers have in providing care to patients in a satisfactory manner. At present, there are around 40 doctors for 100,000 patients in the rural areas and around 53 doctors for 100,000 patients in the urban areas, as stated by Rural Health Web. This stark gap is one of the key driving forces for the adoption of digital applications and mechanisms by healthcare institutions.

Imagine delivering a baby at 24 weeks gestation, or three months early. You deliver at the hospital closest to your house or the one that your OB/GYN recommends.  Exploring the quality of care outcomes in that facility are not at the forefront of your mind. Wanting a healthy baby, or even a baby that simply survives, free of life-altering complications, becomes your goal. Quickly after this baby is born, he is whisked away to the neonatal intensive care unit (NICU), and it may be hours or sometimes even days before you see him again. The clinicians in that unit are trying their very best and they are providing excellent care: or are they? How do you know? Without questioning the intent or skill of clinicians, the data show that the quality of NICU care varies from unit to unit, and one complication in particular can vary widely: necrotizing enterocolitis (NEC). For this condition, there is a core of evidence-based prevention interventions that are essential to reduce the risk of contracting NEC. Perhaps most importantly among these tactics is giving baby the mom’s own milk, using a feeding protocol, limiting antibiotic and antacid exposure, and considering strategies for timely recognition. NEC-Zero is a prevention bundle for NEC and our team has made a concerted effort to share it freely so any unit in any location can deliver excellent care to any baby. However, improving quality is a difficult task, and it requires a committed team to implement the best evidence in the NICU.

The long-awaited promise of telemedicine may finally be realized as a response to Covid-19.

For decades, advocates hailed telemedicine as the way forward to improve access and reduce cost, while maintaining high-quality care. There have been steady gains in investment and growth across the country, and an increasing number of studies suggest that for certain services, namely chronic care management and mental health services, telemedicine may be superior to in-person care. Specifically, studies showed better health outcomes through improved medication adherence, integration of medical tests, and reduced hospital readmissions. However, even with these positive steps, it would be a stretch to claim that telemedicine had transformed the US healthcare system and, in large part, that is because of legal barriers that were in place prior to Covid-19.