Telehealth expands patients' access to care

Special to the Herald-LeaderJuly 14, 2013 

Sprang

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Imagine that during your last visit to your mother's home in Eastern Kentucky, you noticed that she was having memory problems. The closest memory disorder specialist is in Lexington and Mom has made it clear that she feels fine and is not going all the way to Lexington just to see the doctor. So, if you can't bring Mom to the doctor, can you bring the doctor to Mom? In Kentucky, the answer is yes.

Kentucky is a recognized national leader in the use of telehealth or interactive video conference technology used to connect patients and providers who are many miles apart. Telehealth began in Kentucky in 1995, and the first patient seen via telehealth was a young girl who was diagnosed with cardiac problems. The pediatric cardiologist, patient and parents were able to see and hear each other; heart and lung sounds were transmitted by an electronic stethoscope. The echocardiogram done at a community hospital was visible to the cardiologist. Throughout the patient's treatment, she had several follow-up visits via telehealth. Her final telehealth visit was cleared her to begin cheerleading.

Telehealth in Kentucky uses high definition video conference systems in healthcare facilities to bring patients and providers together, helping to reduce the cost and inconvenience of travel. There are more than 200 approved Kentucky Telehealth Network health care facilities across the state where patients can be seen by their health care providers. The network includes hospitals, clinics, public health departments, community mental health centers, public school clinics and the state's three medical schools.

The technology is also used to see prison inmates, eliminating the cost to secure and transport the inmate to a medical facility while protecting the public by keeping inmates inside the prison. One of the largest coal mining companies in the country, with operations in Kentucky uses telehealth to bring health care services directly to the mines, helping employees and their families access needed health care services from the work site.

The most significant obstacle facing telehealth services has been the lack of reimbursement for providers who see patients via telehealth, but over the years, Medicare has expanded its coverage for telehealth encounters, and Kentucky was the first state in the country to pass comprehensive telehealth reimbursement mandates for both Medicaid and private health insurers. Recently, Kentucky's Medicaid program has approved new regulations to expand the providers and services that are eligible to use telehealth.

The patient scenario at the beginning of this article happened. The family was able to bring their mother to their local hospital where she was connected to a specialist on TV. She was diagnosed with Alzheimer's disease and had follow-up care every few months for the next eight years until she died. The family attributed the successful care of their mother to having easy access to specialized medical care and family caregiver support resources through telehealth technology.

Rob Sprang is the director of Kentucky TeleCare. For information about the Kentucky TeleHealth Network, contact him at rsprang@uky.edu.

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