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Medical school’s faculty physicians conquer the digital divide with telehealth and RPM

The COVID-19 pandemic led to an abrupt change to reimbursement of telehealth services, allowing healthcare providers to more broadly expand patient usage of virtual care.

For faculty members in the University of Maryland School of Medicine’s psychiatry and family medicine departments, located in Baltimore, telemedicine services encompass a massive selection of tools that help engage patients, monitor symptoms and offer direct care beyond the confines of a physical location.

During the period of the pandemic, virtual care was implemented out necessarily to mitigate the chance of COVID-19 infection. However, before the pandemic, there have been many barriers to in-person care.

Barriers to in-person care

These barriers included practical considerations (for instance, transportation costs), physical health challenges (for instance, fatigue and illness symptoms rendering it difficult to set off)and emotional issues (for instance, depression and anxiety impacting motivation and comfort with getting into a medical office).

Further, patient monitoring between sessions typically required patients to proactively report symptoms (for instance, call an office, wait on hold, and present symptom updates and any vital sign measurements like blood circulation pressure by phone).

Psychiatry and family medicine staff didn’t have tools to boost the systematic assortment of objective data (for instance, pulse and temperature) and direct transmission of data to the procedure team.

“The opportunities obtainable in telemedicine, however, were initially challenging for most health systems due to the increased demand for equipment and internet connectivity, which impacted both patients and providers,” said Dr. Gloria Reeves, associate professor of psychiatry at the University of Maryland School of Medicine and a practicing child and adolescent psychiatrist at the University of Maryland INFIRMARY.

“Providers who had to quarantine on the pandemic had problems with internet connectivity because they tried to home based, and their clinical teams were initially not built with adequate equipment to conduct large volumes of telemedicine visits,” she continued.

Health disparities from the digital divide

Of serious concern, patients from underserved communities experienced health disparities from the “digital divide,” where those that were already experiencing more difficulty accessing in-person care also had greater difficulty with accessing technology and internet connectivity to take part in virtual care services.

“Inside our COVID-19 experience, we learned all about the great need for timely and comprehensive symptom monitoring to aid treatment decision-making over different phases of illness, but symptom monitoring and engagement in care can be critical for quite typical chronic physical and mental health issues, including depression and hypertension,” Reeves explained.

“We’ve witnessed a big upsurge in vendors for telehealth-related equipment and services, so we encourage health systems to explore emerging options and we usually do not endorse a particular vendor,” she added.

Recipient of an FCC grant

The University of Maryland School of Medicine was awarded $977,066 from the FCC telehealth grant program for the purchase of laptops, internet services, mobile telehealth carts, equipment for vaccine outreach, and vaccine hotline and remote patient monitoring equipment to supply telehealth.

“Our FCC telehealth equipment grant supported virtual care of patients through the University of Maryland School of Medicine Family Medicine and Psychiatry departments,” Reeves said. “We’ve utilized the funds to get equipment and internet hotspots to aid connectivity.

“A considerable obtain our grant was for laptops which you can use securely by clinicians in family medicine and psychiatry for off-site, community-based initiatives, including school-based health programs and vaccine outreach activities, along with office- and home-based telehealth work,” she continued.

The business also purchased remote monitoring equipment which allows the assortment of vital signs from the patient’s home, and the info is transmitted right to the care team. This remote monitoring equipment has internet connectivity and simple instructions to remove barriers for use by patients and also require challenges managing technology or accessing the web.

Uses for RPM

“Remote patient monitoring has been found in patients at risky for severe COVID to control chronic diseaseand to control COVID-19 quarantine,” she said.

“We also purchased mobile telehealth carts, which are increasingly being used in a number of settings, includingthe University of Maryland INFIRMARY, outpatient practicesand community-based programs,”she said. “This equipment can be used for most purposes, including patient monitoring at vaccine clinics, conducting hospital-based consultationsand improving choices for patient-family communication during hospital care.”

The business used internet hotspots for clinicians who provide care in community-based settings, to allow them to securely access information needed in electronic health records to supply and document care. In addition, it offered internet hotspots for patients to greatly help them stay linked to care.

“This support has added collateral benefits because the hotspots may be used by multiple family members for appointments,” Reeves noted. “Finally, we purchased TV monitors and telecommunication headsets that allowed us to provide patient education information in various clinical settings and support timely reaction to health questions.”

Collecting data on the programs

The psychiatry and family medicine departments still come in the procedure ofimplementing new protocols and technologies, so Reeves said it really is premature to talk about any outcomes data.

“The info we have been collecting includes data on both provider and consumer connection with virtual care services, telemedicine service volume, and new applications of technology-based care, for instance, mobile telehealth carts to boost family communication with patients during hospitalizations,” she said.

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