How to Bring Health Care to Rural Communities
Many of us take our health care for granted.
That is, when we don’t feel well, we call our care provider, set up an appointment, get examined, receive treatment, and (we hope!) get better. Overall, it’s a pretty simple thing to do. We might have to miss a few hours of work, or a few classes, or arrange for childcare, but in most cases, we can get treated pretty quickly with very little wear and tear.
Imagine, though, if you lived far away from a primary care provider, specialist, or subspecialist, or if you had some condition that made it difficult or impossible for you to travel long distances to receive necessary medical care. Moreover, think about how difficult it might be for you to receive a house call from a care provider, especially if he or she had to spend several hours in travel time to see you.
This is the reality for many Vermonters, as well as others who live in rural or underserved areas in the United States.
Compared to those in urban areas, people in rural communities have much less access to medical care of all types, even though there are higher proportions of rural men and women with significant medical conditions, or behaviors that place them at risk. For example, higher proportions of rural men are likely to smoke, have hypertension, and impaired renal function. Higher proportions of rural women suffer the health effects of obesity, hypertension, diabetes, and renal impairment. Rural folks are also far less likely to have access to mental health care providers or services, use mental health services less frequently, and have higher suicide rates. Living in the country is great, but there is a downside and rural residents are a vulnerable and underserved population.
So, how can we address this discrepancy?
Telemedicine is the use of medical information exchanged from one site to another via electronic communications to improve a patient’s clinical health status. Telemedicine includes a growing variety of applications and services using two-way video, email, smart phones, wireless tools and other forms of telecommunications technology.
We have had an active Telemedicine program at Fletcher Allen Health Care for almost 20 years with new programs and applications added regularly. Some of our current telemedicine activities include:
- Telepsychiatry consultations for rural nursing home residents
- Pediatric critical care tele-consultations to emergency departments of distant community hospitals
- Tele-palliative care consultations for critically or terminally ill patients who want to receive terminal care in their own community
- Tele-dialysis oversight for patients receiving dialysis at remote dialysis centers.
Applications in development include a teledermatology service and a tele-stroke consultation service, and we are always looking for new ways to grow our program and to serve our community.
If you are a care provider, there may be a way to bring specialty care to one of your patients who might not otherwise receive it; if you are a patient, ask your physician if he or she might consider a telemedicine approach to get you the care you need.
Click here to watch a video about Telemedicine at Fletcher Allen. You can also watch a video interview with Dr. Rabinowitz about telemedicine.
Terry Rabinowitz, MD, is a psychiatrist at Fletcher Allen where he is also clinical director of Telemedicine.