Connecting via Telehealth

Karen S. Rheuban MD. Professor of Pediatrics and Director for the University of Virginia’s (UVA) Center for Telehealth, testified before the Senate Commerce, Science and Transportation’s Subcommittee on Communications, Technology, Innovation and the Internet at the June 20 hearing titled “The Universal Systems Fund and Rural Broadband Investment.”

Dr. Rheuban told the Senators, “Collaborations have been developed to connect the UVA Health System with 153 sites across the Commonwealth. Presently, high definition video teleconferencing, store and forward technologies, remote patient monitoring, and mobile health tools are being used to improve access to healthcare services for people in Virginia.

The Center for Telehealth connects with hospitals, clinics, federally qualified health centers, free clinics, community service boards, health departments, medical practices, dialysis facilities, correctional facilities, PACE programs, rural schools, and skilled nursing facilities.

Also, more than 65,000 live interactive patient consultations and follow-up visits using high definition video teleconferencing have helped more than 3000 patients at home. The visits using remote monitoring tools, have screened more than 2500 patients with diabetes for retinopathy, connected more than 100,000 individuals to teleradiology services, and through EMRs have facilitated more than 2500 e-consults between providers.

In addition, the stroke telemedicine program has supported the evaluation and treatment of more than 1000 rural Virginians resulting in TPA administration rates now exceeding more than 20 percent in rural partner hospitals.

Dr. Rheuban pointed out that the Center has documented a reduction in NICU hospital days for infants born within their high-risk obstetrics telemedicine program serving rural high-risk pregnant women.

In another program, the Center for Telehealth and their partner UVA Remote Care Solutions, launched a program to prevent hospital readmissions for patients with heart failure, acute myocardial infarction, chronic obstructive pulmonary disease, pneumonia, stroke, and joint replacement. So far 30 day readmissions have been reduced by more than 40 percent.

The Center’s telepsychiatry program represents the number one request for services according to Dr. Rheuban. “We offer child and adolescent, adult, emergency, and substance use services. These programs have been shown to be effective with high rates of patient satisfaction.”

To maintain all of the services, the Center for Telehealth is dependent on reliable broadband communications services and in the majority of cases, the Center relies on the FCC Rural Healthcare Program for connectivity between facilities.

Dr. Rheuban and others in the field recommend that the FCC Rural Healthcare Program continue but they want to see the $400 million funding cap previously established by the Commission expanded. If the $400 million funding cap cannot be increased, then explore using additional federal options to support costly infrastructure build-outs. Also, if the funding cap can’t be raised, prioritize rural providers in the program.

Dr. Rheuban’s recommendations also include expanding eligible providers for the Rural Healthcare Program to include emergency medical service providers and community paramedics. Also, she recommends coordinating efforts with NTIA within the Department of Commerce with FirstNet to create a nationwide public safety wireless broadband network for emergency responders.

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