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Program Spotlight: Upper Midwest Telehealth Resource Center

March 13, 2018

IRHA Program Spotlight: Upper Midwest Telehealth Resource Center

by Luke Wortley

So, after the last post about the Indiana Rural School Clinic Network (IRSCN), I got to thinking about the next one. For me, the answer came rather quickly, as I had mentioned telehealth in the last post several times with only a cursory mention of the fact that IRHA is heavily involved in this dynamic and ever-changing field of healthcare delivery. And because the field of telehealth / telemedicine is so multi-dimensional, I’ve decided to do a series of posts on the subject and how IRHA interacts with these various facets, starting with the Upper Midwest Telehealth Resource Center (UMTRC).

At a glance:

- What is UMTRC?: As a federally funded program of the Indiana Rural Health Association (IRHA), the Upper Midwest Telehealth Resource Center provides a comprehensive set of telehealth clinical and technical assistance services leveraged into products of lasting value to rural providers.

- Goal: Provide a single point of contact for telehealth technical assistance (TA) resources across the region through relevant, up-to-date resources on the UMTRC website, relationships with multiple consortium partners in each state and to become a trusted point of contact for all telehealth related questions in the region

- Contact: Becky Sanders, Deena Dodd, Luke Wortley

- Who does the UMTRC serve?: The UMTRC serves rural providers and telehealth stakeholders across a four-state region, which includes: Illinois, Indiana, Michigan, and Ohio.

The briefest of definitions of telehealth:

For a more comprehensive list of FAQs regarding telehealth / telemedicine for both prospective patients and providers, click here. We also gave a brief overview of how telehealth works in the previous article, but for an even briefer refresher, telehealth is, in essence the use of technology to deliver healthcare, health information, or health education at a distance.

A Conversation with UMTRC Director, Becky Sanders:

At any rate, I sat down with IRHA’s own Becky Sanders to pick her brain a bit on the current state of telehealth, its ideal niche within the larger fabric of healthcare, and the future of telehealth / telemedicine. She was kind enough to answer a few of my questions while she was traveling to Savannah, GA for a strategic planning meeting of all 12 regional and 2 national Telehealth Resource Centers.

Q: Many Americans are just now testing the waters of telehealth / telemedicine. But this concept as a remote delivery system isn’t exactly new. About when would you place the sort of “beginning” of telehealth / telemedicine as a concrete entity within the industry?

A: The actual beginning dates all the way back to the 1960s, really. Look up Jay Sanders, MD.

I did look him up, and it was fascinating. While there are many anecdotes and articles on the genesis of the term, I found a blog post the doctor wrote himself in December 2015. In the words of the “Father of Telemedicine,” the first conception of telemedicine stemmed from road rage commuting from Logan Airport to Massachusetts General Hospital.

Q: In as few words as possible, what do you think is the most practical application of telehealth / telemedicine? In other words, what is its most appropriate evolutionary niche within the larger context of healthcare delivery?

A: Most practical – telestroke, teleneurology, and telepsychiatry from the emergency department of a rural hospital to a more urban facility. The final-form evolution – virtual telehealth platforms to see a doctor from your own mobile device / tablet.

For us here in Indiana, the ability of telemedicine to alleviate the burden of inefficient travel and lack of local providers in these fields, particularly psychiatry, is potentially a game-changer. Furthermore, the idea that someone might be able to use their own personal device to set an appointment and be able to receive neurological or psychiatric consultation, education, or even diagnosis is very exciting, though I’m not sure how far off that type of service is in the distance.

Q: What are some challenges with the overall development of telehealth nationally? What do you think is the immediate and long-term future of telehealth / telemedicine nationally, from a practical standpoint (or a legislative one, your choice)?

A: One obstacle is that telehealth technology changes outpace telehealth legislation changes somewhere in the neighborhood of 4 to 1. The newest federal continuing legislation includes language from the Chronic Care Act bill, which is a huge win. This legislation will certainly have immediate impact on billing codes and other aspects of telemedicine. Long term, telehealth won’t be a term. Everything will be in-person care vs virtual/mobile care. And reimbursement will move to some type of ACO-like, risk-based quality care model.

I’m still a relative novice when it comes to telehealth, having joined the staff of the UMTRC in October 2017, so I’m interested to see if the pace of legislation can ever catch up to be comprehensive enough to anticipate innovations in telehealth.

Q: What would you like to see IRHA do with telehealth in the future?

A: I’d like to see IRHA expand the services of the Indiana Telehealth Network to where we sign up providers who want to do telehealth with the healthcare sites on the network. Then the sites wanting a telehealth provider can just pick from a drop-down menu of providers on a fully integrated digital platform whenever they need one. In this fantasy world, all sites would credential all providers by-proxy, and there would be standardized contracts for payment.

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