Telehealth – We’ll Leave the Light on for Ya!

A smart telehealth strategy can determine broadband’s role in mitigating the impact of COVID-19 and providing proper care for patients in converted facilities. But where there’s no broadband, there's no telehealth!

On April 1, Medicare and Medicaid took the handcuffs off of telehealth, making it possible to commandeer a Motel 6 to provide medical treatment via telehealth if hospitals become slammed with COVID-19 patients. A health care system can use hotels or dormitories to take care of patients as long as a hospital oversees these temporary arrangements.

Konrad Bolowich, assistant city manager of Loma Linda, California, has been pilot testing a project of this kind for several years, using telemetry sensors in hotel rooms where patients can stay while physicians monitor them overnight after surgery or another medical procedure. He told me, “It’s much cheaper to rent a hotel room than a hospital bed and probably more relaxing. This has a great potential for impacting rural hospitals.”

New York Governor Andrew Cuomo was already moving in that direction in March, when it became clear the state needed to close a 40,000-hospital-bed deficit. He asked, rhetorically, “How do you create new hospital beds? Take people who are in current hospital beds and move them into converted facilities – people who need a lower level of care.”

Telehealth and community broadband can make this happen. Here’s a look at how.

Wireless in a Hurry

COVID-19 has done nothing if not exposed the fault lines in this country’s broadband infrastructure. This pandemic has caused networks to groan under stress of quickly shifting business, school, and health care data traffic to home broadband networks. That shift also has made glaringly obvious the lack of broadband of any type in too many communities.

However, public-owned and co-op networks have built broadband networks well and relatively quickly, which is good because there’s not a lot of time.

When internet connectivity is needed in a hurry, wireless such as Wi-Fi or fixed wireless may well carry the day. Some lawyers wince at the thought of health care by Wi-Fi. But check out the daily coronavirus numbers and then decide.

“Wireless networks are sturdy and secure, the technology is proven, and it will get you there faster,” says Ron Deus, CEO of NetX Internet, an urban wireless internet service provider. “Also, there are ways to use the equipment after the crisis.” Hotels, motels and dormitories may have fiber already in place that can boost Wi-Fi within or around the properties.

Speed and competence are what we need now. Someone must drive this process of converting facilities, and a county public health department is a logical candidate because it’s nimble. Community broadband network managers should be involved to ensure that converted facilities have appropriate broadband resources.

Telehealth’s Mission: Mitigate Impact of Coronavirus

Aside from monitoring whether patients may have virus symptoms and are in quarantine, there’s not much that telehealth can do in the COVID-19 fight. But the realm of health care for non-COVID patients in converted facilities can be significant.

Telehealth is using intranet and internet networks to diagnose, administer, initiate, assist, monitor, medically intervene and/or report on the continuum of care (CoC) – that is, everything done medically to heal patients. Telehealth is appropriate for every point along the CoC that broadband can influence.

Creating a Telehealth Strategy

Following is a summary of the key elements of a telehealth strategy.

What are the health care needs of non-COVID-19 patients?
Outline a definitive picture of the health care needed by the target populations that can be delivered quickly. Include demographics and a prioritization of patients.

What do we have now (i.e., what’s the actual current state of local health care)?
Relative to the types of patients the converted facilities will house, assess the quality of the  health care available, such as number and skill levels of health care professionals; the quality, availability and affordability of technicians; and the accessibility of radiologists.

What broadband resources are most needed to support facilities?
Resources may include the types of broadband infrastructure, digital equipment, training, digital literacy, portable hotspots and other wireless equipment.

What’s the status of available broadband?
Many communities have a private or public (or both) broadband network already in place. The lucky ones have multiple network owners. The broadband speed and capacity may be all a town needs for its telehealth plan. Make sure health care and community stakeholders are aware of what broadband resources are at their disposal.

What’s the telehealth strategy?
The following are some preliminary tactics that can be included in the final telehealth strategy.

  1. Determine locations and type of telehealth hubs
  2. Designate alternative telehealth locations
  3. Determine telehealth options for low-income, uninsured patients
  4. Understand states’ rules and regulations regarding telehealth (every state’s rules are different)
  5. Create contingency plans

These are uncharted waters, but the good news is that there is a lot of latitude to experiment with new methods of delivering health care. The science of health care allows much less room for improvising. It’s essential to plan – with urgency – or else chaos and mayhem could ensue.  

While trying to deliver telehealth to stem a pandemic, pay attention to digital inequity issues. If Katrina taught us anything, it’s that in a crisis, leave no citizen behind.


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