Supporting Healthy Communities Through Telehealth

Supporting Healthy Communities Through Telehealth

During the recent National Health IT Week (September 23 to 27),  the need to expand access to telehealth services was underscored as a critical component of supporting healthy communities. 


Among the points of engagement for the nationwide action week was demonstrating the power of IT to transform health in the U.S. and around the globe. Aside from the need to expand access to broadband and telehealth, other actionable outcomes include advancing public and population, modernizing public health information infrastructure, accelerating workforce development, and addressing social determinants of health.


The Healthcare Information and Management Systems Society (HIMSS) and the Institute for e-Policy founded the U.S. National Health IT Week in 2006 to catalyze change within the U.S. health system through the application of information and technology. 


For telehealth, the need to expand access is more pronounced now than ever before. In today’s digital world, no patient should be too remote to access care. But in the U.S. there are 19 million people who are in underserved rural areas still lacking access to broadband or equivalent wireless service, an essential part of increasing access to care through telehealth.


Without access to this vital service, clinicians’ ability to provide care remotely is challenged where research shows many of these rural areas experience high rates of chronic disease. Access to telehealth can help effectively control and monitor patients’ health in these areas, and aid early intervention to support healthy communities.


As an accessible communication hub, telehealth enables two-way communication between patients and healthcare providers, as well as interactions between physicians and health care professionals. But there’s more to it than just email, text or a phone call to set doctor appointments or reminders for scheduled consultations. Those are just modes of communication, context and content are crucial.


Telestroke, Tele-ICU & Tele-Retinopathy


According to the California Telehealth Resource Center (CALTRC), tele-stroke programs have provided timely treatments that effectively reverse the consequences of a stroke from 15% to 85%. Telestroke, also called stroke telemedicine, is the use of digital video cameras, Internet telecommunications, robotic telepresence, smartphones, tablets, and other technology by doctors who are more advanced when it comes to treating strokes, as well as treating people who have had strokes in another location.


Telehealth support enables the right kind of expert care for stroke patients in hospitals that don’t have neurologists on site. Through technology, a non-specialist doctor and the doctor trained in treating strokes work together remotely to provide care right there in the community, avoiding the need for transfer to another medical center. 


Meanwhile, an intensive care unit (ICU) powered by telehealth, also known as tele-ICU or eICU, is reducing mortality rates by 15 – 30% and substantially reducing complications and length of stay.


According to The Medical Futurist, to address the shortage of qualified intensive care doctors, eICU was designed based on a hub-and-spoke service model, to have doctors in two places at once. “The hub is housing teams of medical professionals and their workstations, while the spokes going out to client ICUs.” 


It began first as an experiment in Cleveland Ohio in the 1970s, but there are now approximately 50 eICU hubs in the US and several international ones.


Early intervention where telehealth has also proven to be effective is in the early identification of serious eye disease and reducing the incidence of blindness in diabetic patients through tele-retinopathy screening programs. Hence, communication platforms allowing low bandwidth modes communication between patients and providers/clinicians coupled with key content and context, valuable to both, play a key role.


Findings on the use of telehealth screening to detect diabetic retinopathy and other ocular findings in primary care settings have concluded that telehealth retinopathy screenings have a significant impact on the early detection and prevention of vision loss for diabetic patients.


The business case of telehealth, in this case, is in relation to helping improve health outcomes for less costly treatments. Remote monitoring programs reduce wait times and costly hospital visits and re-admissions. It addresses the shortages of healthcare providers and improves hospital organizational productivity.


According to CALTRC, the improved outcomes and cost-savings of telehealth have reduced hospital visits by 50%, as patients with chronic diseases have been kept stable through daily monitoring from home. Telehealth monitoring programs have also reduced the national average for readmission to hospitals within 30 days following a heart failure episode from 20% to less than 4%.


For all that telehealth can do for professionals, it’s when patients are participants that it is most empowering. A patient that is engaged in his/her own health is empowered to make more informed decisions leading to improved clinical outcomes.


An empowered patient is what a patient engagement platform breeds. It enables dialogue between the patient, his/her family, clinicians, and other healthcare providers;  effectively creating a community of care. When the community of care is involved, enabled through telehealth solutions and patient participation platforms, you unlock a pathway to a healthy community. 



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