Why rural America needs telehealth

Time is brain. This is a phrase physicians use when talking about a stroke. Because for every minute that passes, an estimated 14 billion synapses, the building blocks that are responsible for brain functions like learning, memory, and behavior, are lost. It means the longer it takes for a person to access care, the worse the outcome can be. In rural America, local hospitals are less likely to have specialists on staff. And because of that, stroke patients in rural areas are more likely to die than stroke patients in urban settings. But we have the technology to change these outcomes. It's called Telstroke, a form of tellahalth that allows a stroke specialist from anywhere to dial in, assess a patient, read brain scans, and quickly prescribe life-saving drugs or recommend a transfer. Studies have found that it's effective at reducing mortality in rural stroke patients. The trouble is, tellahalth services like this are frequently underfunded, undervalued, and underutilized. But when tellah health is used correctly, proponents say it stands a chance at radically altering rural healthcare for the better. But how effective can virtual care really be and what's standing in its way? This is another video we're doing about how emergency help gets to remote places. Rural areas in the US often struggle to get the same services as more populated regions. And we wanted to explore what some of those challenges look like and what might be done to make things better. And thanks to our sponsor, T-Mobile for supporting this video. T-Mobile is now the best mobile network in the US according to the UK Speed Test and continues to be committed to supporting first responders and their families with exclusive savings. You can find out more at the link below. T-Mobile didn't dictate the content of this video, but their support did make our reporting possible. Now, back to the video. Tella health is less of a singular thing and more of a tool kit. Let me explain. Most people think it looks like this with a doctor and that is one type. It's called interactive tele medicine. It includes the obvious things like phone calls or video calls. But there are two other versions of tellahalth that have been in use for decades. Remote monitoring allows physicians to monitor patients in their everyday lives using a medical device. It was actually first developed by NASA during the space race to monitor the health of astronauts. Today, this can be as simple as a blood pressure cuff equipped with Bluetooth to send real-time information to a physician. There's also store and forward tele medicine. This is when a patient might be evaluated by a nurse or doctor in one location and then that information is sent off to a specialist in another location. This first came about in the 40s with the development of terraiology. The tech was extremely limited at the time. Radiographic images were sent via telephone lines. As you can imagine, it took a while. Today, it's as simple as uploading a file like an X-ray, CT scan, or MRI. >> So many different models of tele medicine, but all with the same goal, connecting providers and patients when they're not in the same room. The desire, or really need for this kind of care spans decades. This article from the Lancet recounts a story from 1879. A concerned mother phoned her family doctor in the middle of the night, convinced that her baby had CRO, a respiratory infection with a distinct cough. The doctor was able to listen to the phone and declared that wasn't the case. But more recently, we saw a massive uptick in the widespread use of tellahalth. Starting here, March 2020, at the start of the co 19 pandemic, policymakers loosened restrictions on tellahalth. Before the pandemic, physicians had to get lensure in different states in order to treat patients even through tele medicine and that was lifted during the pandemic. They also expanded how it was covered. Medicare would not cover tele medicine for a patient other than in a facility in a rural area. But by opening it up to urban facilities um to the home, we were able to scale massively. The pandemic is over, but there's still a healthcare crisis in rural America, and tellahalth could play a huge role in closing those gaps. Here's how. There are a few key challenges for rural healthcare in the United States. We'll narrow it down to three. One is the distance a patient has to travel for care. Analysis from the Pew Research Center found that on average, rural Americans have to travel about twice as far to a hospital compared to those in urban or suburban areas. >> These hospitals are serving several thousand square miles. So, you know, people might have to drive a good amount in order to get there and that's just not always possible. >> Now, hospitals in rural areas are often the only healthcare. So, when we're talking about distance to a hospital, we're not just talking about emergency services. It's often primary care and lab services and even pharmaceuticals. >> People tend to avoid care. They tend to not go when they need to and that just exacerbates the issues. Tellah health could mitigate this especially in non-emergency situations. For example, if a patient needs an operation, they would typically have to make multiple trips. >> Prior to tele medicine, they would have to drive to the pre-op center to get their screenings before anesthesia and then go back home and then come back for their surgical procedure. Now, we can accomplish that virtually. >> A lot of post-top physical therapy could also be handled virtually to save the patient time and money. The second problem for rural healthcare is workforce shortages. It's harder for rural areas to recruit doctors, nurses, and especially full-time specialists. >> We can um mitigate some of those workforce shortages by using video visits, connecting the hospital with the tertiary or quatinary care hospital. >> Some rural areas have specialists that come in as little as twice a month. But with teleaalth, >> their patients can still have access to that specialist um and have that relationship with that specialist. >> Finally, the third main problem for rural healthcare is money. Smalltown hospitals have very thin margins. Many of them operate just above or even in the red. Tellahalth helps keep patients in local facilities which keeps the money there. Telstroke, for example, has been found to reduce hospital transfers up to 50 or even 60% in some areas. A specialist provides a treatment plan from another location and the on-site staff can carry that out. Basically, it gives those local facilities more options to keep revenue in house, which of course is good for the patient as well. As time goes on, tellahalth devices are getting better and less expensive, making it more accessible for lower inome communities. When done right, >> the ability to do tellahalth has really brought healthcare to a ton more people, has helped them really identify issues earlier and treat them earlier. So, they're finding healthier communities as well. >> But there are some major caveats here. We need to do a better job of educating because not everyone in rural America understands technology, >> which means setting up things like digital navigation training for patients. Ruben and her team are also working with communities to set up private teleahalth centers within community centers and libraries. Another very big issue is connectivity. Broadband access in rural areas is still extremely limited compared to urban areas. even having all the devices, even having the specialists there um and ready for them 24/7 could not mean much if they can't get connectivity. >> And finally, those pandemic era bills that led to this huge leap in telealth services are set to expire at the end of September 2025. Luckily, it looks like there's bipartisan support to extend those bills. So, the goal here isn't to have Tellah Health replace inerson visits with a doctor. It's to supplement and enhance care whenever possible. What I believe quite frankly is tele medicine isn't going to be tele medicine. It's just health care in the 21st century and going forward. The technology is there. Most of the public policies are in place. Not all, but we're hopeful that that will happen. And then it's just ubiquitous care. It's a tool that's available to patients.