The Arizona Telemedicine Program Blog, Category: mHealth

For medical students with the University of Arizona College of Medicine – Tucson, weeks of suspense will end on March 15. Otherwise known as Match Day, it’s the day the students will learn where they will go for their residency training, in their chosen medical field, after they graduate from medical school in May.

Sarah Joy Ring, who has completed the College of Medicine – Tucson’s Rural Health Professions Program and a 16-week Rural Health Distinction Track, is hoping for a residency focused on both pediatrics and emergency medicine, potentially in a rural location.  Her “capstone” paper, an in-depth research project that all Distinction Track students are expected to complete, carries the impressive title of “A Survey of Rural Emergency Medicine and the Discrepancy of Care for Pediatric Patients that Present to Rural Emergency Departments.”

After four challenging years as a medical student – while maintaining her roles as a wife and mother of five daughters – Mary Alyson Smith will graduate from the University of Arizona College of Medicine-Tucson, in May. She has decided to pursue a career in pathology, and is especially interested in telepathology, “I feel it’s an area that still has great potential for growth,” she says.

But there’s more to Mary’s medical training. In addition to the usual four years of study, Mary applied and was one of 26 students accepted to the UA College of Medicine’s Rural Health Professions Program (RHPP), designed to broaden students’ knowledge of healthcare delivery by matching them with physician preceptors working in small towns, including Indian Health Service sites, throughout Arizona.

When implementing a telemedicine program, you should create a new workflow. It’s easier to adapt a current workflow into the technology than to create a new productivity model. Your daily processes will need some changes but not entirely, and this can be to your advantage.

After your workflow model is altered – and it’s an easy process if done properly -- you can integrate it slowly into your daily practice. This will make this easier for you and your patients.

When Summit Healthcare in Show Low, AZ, lost its inpatient dialysis service and its two local nephrologists in 2016, it was no longer able to provide dialysis for patients who were hospitalized. Instead, Summit had to transport these patients to a hospital in Phoenix, Tucson or Flagstaff, where they could receive not only acute inpatient services but also inpatient dialysis. These transports, nearly always via air medical services, cost on average $42,000 per flight.

Word quickly got around the local dialysis community that if you were admitted at Summit for an inpatient stay (say for appendicitis or pneumonia), you would have to be transported to a metropolitan hospital so you could receive your needed dialysis as an inpatient. These patients started avoiding the Summit Emergency Department—and necessary healthcare—because they knew they would be flown out to a larger city.

In May of 2018, the United States Department of Veterans Affairs (VA) introduced new legislation that would allow network healthcare providers to treat veterans using telehealth technology. The VA has extended this privilege across state lines.

During the announcement of the new legislation, the Veterans Administration also introduced VA Video Connect, a video conferencing app created especially for veterans and VA care providers. The innovations allow care providers to deliver services no matter where physicians or patients are located.

The Veterans Administration collaborated closely with the White House Office of American Innovation and the Department of Justice to draft the new law. They partnered from the original incarnation of the law as the "Authority of Healthcare Providers to Practice Telehealth" to its new name called "Anywhere to Anywhere." The ruling is essential for supporting initiatives designed to improve the accessibility and quality of healthcare services for veterans.