Neonatal telemedicine in Hastings, Faribault, New Ulm, Buffalo, Cambridge and Minneapolis

I’m written about neonatal care in Cambridge and Mayo Clinic but it looks like it’s spreading as Becker Hospital Review reports…

Minneapolis-based Children’s Minnesota Health System will provide neonatal care delivered via telemedicine technology to six hospitals across Minnesota and Wisconsin, according to a Feb. 20 news release.

The partnering hospitals include Regina Medical Center (Hastings, Minn.), District One Hospital (Faribault, Minn.), New Ulm (Minn.) Medical Center, Buffalo (Minn.) Hospital, Cambridge (Minn.) Medical Center and Western Wisconsin Health (Baldwin, Wis.).

Through the partnerships, physicians can participate in a virtual consultation using audio and video technology with a neonatal clinician from Children’s Minnesota.

“Expert, specialized care should be available to all newborns, regardless of where they’re born,” said Mark Bergeron, MD, director of special care nurseries and neonatal virtual care at Children’s Minnesota. “These partnerships bring us one step closer to that reality…”

Senator Smith talks housing and telehealth on reservations in Northern Minnesota

Duluth News Tribune reports on Senator Smith’s recent visit to the American Indian Community Housing Organization and Fond du Lac Center for American Indian Resources. The visit focused largely on access to housing and healthcare. Broadband came up as a tool to help with health care…

Solutions may require thinking outside the box. Increased access to broadband could bring more telehealth opportunities — allowing doctors to treat patients without traveling hundreds of miles. Better access to affordable child care could help recruit professionals to smaller communities.

And while broadband didn’t specifically come up in the discussion of encouraging more young people to go into health care, I think that remote classes might help, especially if part of the end goal is to facilitate more telehealth…

Smith said there will not be a “simple fix” to rural health care woes, but told the News Tribune at the end of her visit that the firsthand accounts provide valuable guidance for her work.

“I think one of the biggest things we need to do is figure out how to help young people understand what opportunities there are for really fulfilling and purposeful and profitable careers in health care beyond the idea of going to medical school,” she said. “We need people to go to medical school, but we also need physician’s assistants and nurse practitioners and nurse assistants and personal-care attendants.

“There’s a whole continuum of opportunities that we need to get people interested in.”

Digital health clinic for men and MN bill to facilitate telemedicine for men

I read a lot of different things in a day. But I don’t read a lot about erectile dysfunction, until this week. I have been reading the bill as they have been introduced this week to scan for anything related to broadband. I have a growing list that I will share soon of items that have a loose connection. Doing that I ran into SF2184/HF2150, a bill to allow telemedicine evaluations to be used for erectile dysfunction medication prescribing. It seemed strange, but again not my wheelhouse.

It made more sense once I ran into an article in Fortune magazine on telehealth…

Telehealth firm Ro just launched what it’s dubbing a “digital health clinic for men” via its men’s health-focused arm Roman.

The company, which has its roots in the direct-to-consumer erectile dysfunction market, has recently expanded its ambitions beyond the men’s health space, including with telehealth services for smoking cessation and a vertical meant to advise women who are about to go through menopause.

But the new effort underscores how important the men’s health business is to Ro’s portfolio.

There’s a tie into medications…

I spoke with Ro’s CEO, Zachariah Reitano, a few weeks ago about a separate project the company was working on—a partnership with drug giant Pfizer meant to leapfrog the company’s rivals in the generic Viagra space.

Here’s how Reitano described the importance of that partnership: “I compare it to buying coffee. You can buy coffee at two different places. All the coffee contains caffeine. But so many things go into making that cup of coffee that go into the quality of that product and experience.”

The comparison is intriguing. And Ro’s efforts in this crowded market could be a signal for how other telehealth companies follow.

So I mention this as a new avenue for telehealth and maybe a civics lesson.

Distance Learning and Telemedicine Program application open until April 10, 2020

Big news, big opportunity

U.S. Department of Agriculture (USDA) Deputy Under Secretary for Rural Development Donald “DJ” LaVoy today announced that USDA is accepting applications for grants to help increase access to education, training and health care resources in rural communities.
USDA is making $71.7 million in grants available under the Distance Learning and Telemedicine Grant program. This program helps rural communities use telecommunications-based audio and video equipment to connect teachers, students, medical providers and rural residents with each other and the world.
Applicants in rural areas of 20,000 people or less who provide education or health care services through
telecommunications facilities are eligible to apply. Applications will be scored, reviewed and selected on a
competitive basis.
Applications must be submitted to the applicant’s nearest USDA office or electronically via grants.gov by
April, 10, 2020. For more information, visit grants.gov.

Learn more and good luck!

More on USDA ReConnect project with Harmony Telephone (Fillmore County)

The Post Bulletin reports…

Access to high-speed broadband technology has been limited for many rural residents and efforts to ensure availability have been slow despite the best efforts of Minnesota state government.

That’s why it was a momentous occasion last month when the U.S. Department of Agriculture announced that it will invest $11 million in three high-speed broadband infrastructure projects in southeastern Minnesota and northern Iowa.

The funds will benefit more than 1,395 rural households and 120 businesses. The funds will be allocated to Harmony Telephone Co., Consolidated Telephone Co., and Osage Municipal Utilities.

The article highlights the benefits of rural broadband, emphasizing healthcare…

Expanded broadband opportunities would improve health care for rural residents, improve education for students, help farmers keep updated on rapidly changing markets, create an environment for better paying and more rewarding jobs, and entice more urban residents to live and work in rural communities.

Telemedicine – so important in rural areas where health care professionals are scarce – would thrive with more broadband access. It’s estimated that nationally only 8.2 percent of patient-healthcare interactions occur via telemedicine, a percentage that would increase if broadband access was available. Telemedicine, of course, connects patients in rural communities with health-care professionals miles away. It can save time, money and lives. Of course, gigabyte gobbling videoconferencing, as well as large data transfers of say, an X-ray, require broadband connection. When a community doesn’t have broadband access, health care institutions are far less likely to consider telemedicine opportunities.

Mayo Clinic Study finds Telehealth sharply reduces risk of death within 30 days

mHealth Intelligence reports…

Two rural hospitals using an asynchronous telehealth platform for eConsults with infectious disease experts saw a sharp reduction in risk of death within 30 days, as well as a decreased risk of rehospitalization.

In a 2018 study conducted by The Mayo Clinic at two hospitals within its network, the connected health platform helped staff at these hospitals collaborate with ID specialists at Mayo’s Rochester hospital on care management for some 100 patients. Through the eConsult platform, those experts were able to recommend interventions like antibiotic type change, antibiotic duration change, antibiotic de-escalation, additional lab testing and consults with other specialists.

“We believe that this study demonstrates the utility of an asynchronous approach to infectious diseases care for patients hospitalized at locations without in-person ID specialists,” Aaron J. Tande, MD, an infectious diseases specialist at the Mayo Clinic and the study’s lead author, told Healio. “This approach allows a more in-depth evaluation of a patient than a typical ‘curbside’ phone call but avoids the complexity of synchronous/video telehealth.”

“This is a potential option for small hospitals that are on the same electronic record as larger hospitals that have infectious diseases specialists,” he added. “We feel that the future of ID telemedicine should include a variety of options individualized to the complexity and needs of each individual patient and capabilities of each health care facility.”

The study, conducted at the Mayo Clinic’s Austin Hospital and Albert Lea Hospital in southeastern Minnesota, saw a 70 percent reduced risk of death within 30 days and a trend toward decreased readmission within 30 days. And while it showed an increase in length of stay, Tande and his colleagues noted that the eConsults were conducted a few days into the hospitalization, and that an earlier consult would likely reduce the length of stay.

 

Portable CT scanner and broadband buy precious minutes in stroke detection

The Sentinel Tribune (Ohio) reports

The new mobile stroke unit is one of only 20, worldwide, with a new portable head CT scanner. Mercy Health has it in a specially-outfitted ambulance with a team trained to work remotely with doctors.

Dr. Eugene Lin, a neuroendovascular surgeon, demonstrated how he can remotely diagnose a patient and have 40-60 CT scan images sent to a radiologist for review. The team can then determine the next course of action, which could include medication and the next facility for ideal patient care, possibly with a comprehensive stroke unit.

Because stroke care is so time sensitive, the Mercy system has chosen to base their mobile unit at the St. Charles location in Oregon. It has the most central location in Northwest Ohio, within a 15-minute drive for rural patients.

Lin described situations where the mobile unit had paramedics contact him with video phone technology and he diagnosed the situation, sitting in his car, at a restaurant parking lot. then the mobile stroke unit met the paramedics at a halfway point to administer emergency care.

“Time is brain with a stroke patient,” Lin said. “We need to get the patient medication to dissolve a clot. We have to make sure we have that information as soon as possible. So having 4G available, having mobile hot spots with enough bandwidth for video streaming and to transmit the images to the cloud so we can view in real time… that’s how I’m able to do everything from one location.”

When Lin started in 2008 a treatment speed of 60 minutes was a goal. Now the unit has treated patients in as little as 11 minutes.

Although this isn’t from Minnesota, it hits home for me. My dad had a stroke a year ago. He was driving and somehow managed to drive himself to the hospital. (And is now fine.) BUT we live in St Paul. Using US Hospital Finder, I can tell you here are 12 hospitals within 5 miles of my house; beyond qualified physicians, at least two have specialized stroke centers.

Everyone should have such access to healthcare – and thanks to telemedicine innovations we’re getting closer to equitable access, despite the shortage of doctors and aging rural population the article mentions. The article outlines some of the financial and policy efforts in play to help expand telehealth more quickly…

In July 2019, the FCC proposed to establish a three-year, $100 million Connected Care Pilot program that would support bringing telehealth services directly to low-income patients and veterans. The program would provide an 85% discount on connectivity from broadband-enabled telehealth services that connect patients directly to their doctors. The FCC is still collecting public comment on this Notice of Proposed Rulemaking.

“Increasing access to reliable and affordable broadband will allow us to better capture all of its benefits and ensure more people have access to the care and services they need,” Latta said.

Along with the commission’s actions, Latta introduced a bill – the Broadband DATA Act – that has passed the House, to fix the national broadband maps. The Broadband DATA Act would improve broadband map accuracy so that federal resources can be distributed to communities that currently do not currently have the digital capabilities, specifically in rural areas, needed to keep pace with the rest of the country. It would get internet connectivity to areas for things like telehealth, homework or streaming a favorite television show.