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Telemedicine: Care Transitions when Distance is a Factor by Nancy B. Finn

The following blog post is reprinted from The Emmi Blog Engaging the Patient from EMMI Solutions

Bob is a farmer who lives in rural Minnesota. He was severely burned on his hands, chest, and back while fixing some farm machinery. Initially, he was treated at a local hospital, stabilized and then transferred to the Regional Burn Center in Rochester, Minnesota, 450 miles from his home. Once Bob was released, he arranged for his follow-up care to be handled over the St. Alexius Telecare network of North Dakota. He participated in three telemedicine visits, each lasting 30 minutes, avoiding a two-day trip. This long-distance care enabled Bob to keep the farm going. It also provided relief to the family, because they did not have to transport him 450 miles and back.(1)

For patients like Bob who are going from a hospital or rehabilitation facility to their home, but live hundreds or thousands of miles from the facility, telemedicine/telehealth can provide care and monitoring, or consulting from super-specialists who provide the knowledge and expertise needed for a catastrophic illness, emergency, or a care transition.

Using the broadband technology which is so widely available today, telemedicine technology enables health centers and hospitals to reach out to patient populations that are challenged by distance, limited mobility, and limited health literacy. For example, a wide range of diagnostic and rehabilitation therapies can be deployed via telemedicine including:

Physical  and Occupational Therapy

Using video/audio conferencing systems, along with instructions that are mailed to patients, or included in their discharge materials, physical therapists can illustrate various stretches and exercises and instruct patients how to move in a particular manner to help them recover from surgeries such as hip and knee replacements, strokes, and other skeletal conditions. The patient and the distant healthcare provider can see and hear each other using full-motion video and digital audio systems. Seeing demonstrations of things like physical therapy exercises helps ensure patient understanding in a way that written descriptions and still images do not.

Mental Health Counselling

Using a closed circuit video system, mental health professionals can have face to face conversations with patients, help them manage their medications and address their concerns. For example, people may stop taking medication for something like depression if they don’t feel the medication is helping. But this can provide an opportunity to remind them that it can take many weeks before they can tell if it’s  making a difference.

Chronic Condition Management

Telemedicine can help deliver specific instructions for a particular chronic condition such as diabetes or heart failure. For example, patients can send vital information about their blood sugar to a diabetes educator and via telemedicine can get instructions on how to adjust their diet or medication.

Patient Education and Health Literacy

Telemedicine networks can also help educate patients how to manage and monitor chronic conditions.  The educator is at one end of the video link and the patient, family members, and caregivers are at the other end. They can have a conversation, and when arrangements are made to have a translator, in the patient/family’s native language, view videos, get instructions, and send and receive data that measures and monitors the patient’s condition. This complete loop creates an open dialogue that helps patients and their families understand and manage their own health in a more effective way.

Telemedicine is providing patients with better information in a way that helps ensure the understand and can manage their health without making long trips back to the hospital.

1. Excerpt from: e-Patients Live Longer, the Complete Guide to Managing Health Care Using Technology. Nancy B. Finn, based on interview with Nina Antoniotti, Marshfield Clinic, Telehealth Network, Marshfield, Wisconsin, February 2010.


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