Telehealth helps better serve rural Veterans

The US Department for Veteran Affairs reports…

Approximately a quarter of all Veterans in the United States live in rural areas. Air Force Veteran Bill Nelson is one of them. As the survivor of three heart attacks, he’s a big fan of one particular VA office and their telehealth program.

The job of VA’s Office of Rural Health (ORH) is to increase access to care for the nearly three million Veterans living in rural communities who rely on VA for health care. As VA’s lead advocate for rural Veterans, ORH works to see that America’s Veterans thrive in rural communities.

Nelson benefits from ORH’s remote home-based delivery of cardiac rehabilitation which uses telehealth to eliminate the need for rural Veterans to travel multiple times a week to a rehabilitation facility. It lets Veterans tailor the location and schedule of their rehab session from their home.

Nelson lives in Maple Grove, which may not be the most rural town I mention this week, but it would be a long drive to the VA hospital in the Cities. It would easily save him an hour drive each remote visit…

In addition to his exposure to Agent Orange in Vietnam, he had a separated shoulder surgically repaired in Okinawa. He is 100 percent disabled due to his service-connected injuries.

Nelson suffered his first heart attack in 1999 which required having stents implanted. He joined VA for healthcare after retirement in 2014. His second heart attack occurred in 2008 which required having more stints implanted. His had his third heart attack in 2018 and had even more stints implanted.

Today, ORH enables Veteran patients like Nelson to first meet in-person with a specialist to safely learn rehabilitation exercises, with subsequent sessions conducted at home.

Regularly scheduled phone calls with the rehabilitation specialist are used to review risk factors, such as smoking cessation and proper nutrition. Other discussions include exercise, medication adherence, and stress management


BestBuy sells device to help telehealth patients have better remote exams

I find this amazing and obvious at the same time. Health Leaders Media reports…

The physical divide between telehealth providers and consumers has now been compressed thanks to TytoHome, a handheld device that enables patients to conduct remote exams from their home and transmit the data through a smartphone.

Manufactured by Tyto Care, the digital kit is now available through, as well as from participating health systems, including Ochsner Health System, based in New Orleans, and Sanford Health, headquartered in Sioux Falls, South Dakota. Most kits purchased directly through Best Buy will connect consumers to physicians at LiveHealth Online, setting up a national caller base for the telehealth provider.

The TytoHome portable examination device features a touch screen that guides patients through the exam process and has attachments that capture digital heart and lung sounds; body temperature; and images of the skin, ears, and throat. The data can be used during live video encounters with physicians or stored on a mobile app and forwarded for review by a clinician at a later time. An online video demonstrates how the product can be used.

The platform also allows for simple integration with electronic health records, third party exam tools, and other telehealth platforms.

I think this could open a door to folks who don’t like going to the doctor. It will make life easier for parents who can use it to report on their kids. For folks in remote areas this means you can have a more meaningful remote visit and not miss a day of work.

Telehealth use doubles between 2016 and 2017

According to Multi-Briefs Exclusive

Telehealth use rose by more than 50% from 2016 to 2017, according to a new white paper by Fair Health. For the annually released paper, data was collected from the company’s records of 28 billion commercial insurance claims, which showed that telehealth utilization grew nearly twice as fast in urban areas vs. rural over that span.

Nationally, urgent-care centers increased their use of telehealth by at least 14%, followed by retail clinics at 7% and ambulatory surgery centers at 6%. Emergency department utilization of telehealth declined, though, by 2%. However, utilization in this setting was still the most used.

Also on the upswing was utilization by private insurance claims for telehealth services, increasing more than 1,200% from 2012 to 2017. Likewise, the use of telehealth is outpacing all other sites of care, the report says.

In 2017, most people used telehealth for injuries like bruises and open wounds, acute respiratory infections and digestive problems. Mental health, which topped the telehealth utilization list in 2016, was fifth in 2017 at 7% of claims, compared with 13% for the aforementioned uses. Per the report, pediatric visits and young adults were well-served, but the age 31 to 60 demographic continued to use it the most.

And interesting note – Minnesota was one of the top telehealth claim reporters in 2016 – but not in 2017. IN fact none of the top users in 2016 were top users in 2017. It shows the speed with which telehealth is catching on.

Senator Tina Smith Introduces Bipartisan Bills to Invest in Rural Communities

News from Senator Smith…

Senators’ Legislation Seeks to Spur Rural Broadband Expansion and Make Sure Rural Health Clinics Continue Serving Minnesotans, Americans Across the Nation

WASHINGTON D.C. [04/04/2019]— This week, U.S. Senator Tina Smith helped introduce a pair of bipartisan bills to expand investments in rural communities: one designed to help improve rural broadband, and one to improve rural health care.

Sen. Smith has been contacted by several Minnesota cooperatives—which are a vital part of the effort to build out rural broadband in the state—that are at risk of losing their tax-exempt status due to a mistake in the 2017 tax law. The mistake in the 2017 law put the tax-exempt status of co-ops at risk if they receive government grants to expand broadband or to recover from a natural disaster. The Revitalizing Underdeveloped Rural Areas and Lands (RURAL) Act, that she introduced with Sen. Rob Portman (R-Ohio) would fix that error that hinders rural broadband expansion. Their bill would ensure that co-ops can retain their tax exemptions in efforts to expand rural broadband or in providing relief from, or preparation for, a disaster or emergency.

Right now, there are 96 Rural Health Clinics in Minnesota and over 4,400 across the country, which help provide care to over 7 million people in 47 states. But these clinics are governed by a set of regulations that haven’t been updated in decades. Sens. Smith introduced the bill with Sen. John Barrasso (R-Wyo.)—called the Rural Health Clinic Modernization Act—would modernize these decades-old rules that are preventing communities from getting the best possible care at Rural Health Clinics. For example, the legislation would expand the ability of physician assistants and nurse practitioners to provide care in these clinics, and improve the ability of clinics to offer telehealth services.

“At the end of the day, it’s my job to make sure that when Minnesotans tell me what Washington needs to do in order to better work for them, they know that I’m listening and working with fellow lawmakers to get things done on their behalf,” said Sen. Smith. “So when I heard from rural Minnesota cooperatives and health clinics about fixes that need to happen, I got to work. These bipartisan bills are good for people in rural Minnesota, rural Ohio, rural Wyoming—and rural communities across the country. Democrats and Republicans alike supporting efforts to allow rural broadband to keep expanding, and to make sure rural clinics stay open, shows what we can accomplish when we come together with commonsense fixes to make life better for Americans.”

The RURAL Act would revert the tax-exempt issue back to pre-2017 tax bill rules and address longstanding issues with the tax treatment of disaster relief grants, and the Rural Health Clinic Modernization Act would:

  • Ease the physician shortage in rural areas by expanding the ability of physician assistants and nurse practitioners to provide care in Rural Health Clinics;
  • Make sure Rural Health Clinics that are not connected to a hospital—as are many in Minnesota—can still use hospitals’ lab equipment because it’s often more cost-effective for these clinics to use the hospitals’ lab equipment;
  • Increase the cap on the amount that Rural Health Clinics are able to bill Medicare for services; and
  • Remove a restriction that prevents clinicians at Rural Health Clinics from providing services via telehealth.

MN is looking for Minnesota E-health Advisory Committee Members

The Office of the Minnesota Secretary of State today released notice of vacancies for various state boards, councils and committees that are accepting applications. Minnesotans are encouraged to apply and serve in demonstration of public service. The newest vacancies are listed below, and the full list of 865 vacancies can be found on their website Open Positions.

There were some positions that seemed of potential interest…

Minnesota E-health Advisory Committee
Vacancies: 1 Seat — Academics and Research
Vacancies: 1 Seat — Consumer Member
Vacancies: 1 Seat — Health Care Purchasers and Employers
Vacancies: 1 Seat — Professional with Expert Knowledge in Health IT
Vacancies: 2 Seats — Rotating Professionals – Additional Health Settings (Dentists, Pharmacists, Behavior Health Laboratory, Home Health, Social Services, etc)

How can broadband help with the opioid crisis? Minnesota has a way!

By providing a way to get best practices to many people! mHealth Intelligence reports…

Critics may be bemoaning the slow adoption rate of telehealth services for substance abuse treatment, but one network of healthcare providers in Minnesota is making strides with a connected care platform – and planning an expansion.

The Minnesota Department of Health’s (MDH) Opioid Prevention Pilot Project, launched in 2017 with $1 million in state funding, has seen success in reducing patient pill use while increasing both the numbers of Minnesotans getting treatment and the rural providers able to provide that care. Now Gov. Tim Walz wants to add 20 communities to the eight-community program and expand the telemedicine service to allow more participation.

“The early success and proven track record of these pilot projects is encouraging,” Minnesota Health Commissioner Jan Malcolm said in a recent news release. “By scaling up the effort, we hope to bring the positive impact to many more communities across the state.”

Here’s more about the network…

In Minnesota, the hub of this hub-and-spoke telemedicine network is CHI St. Gabriel’s Family Medical Center in Little Falls. Officials there say the program has helped the clinic reduce patient pill use by 724,000 pills per year, tapered about 670 patients off of controlled substance prescriptions and now provides about 90 patients medication-assisted treatment.

Based on the success of the clinic’s three-year program, state officials created the eight-member Project ECHO pilot in 2017. It consists of the Alexandria Clinic at Douglas County Hospital, Carris Health Redwood Falls Clinic, Chippewa County Montevideo Hospital, Fairview Mesaba Clinics in Hibbing, FirstLight Health System in Mora, Lake Region Healthcare in Fergus Falls, the Mille Lacs Band of Ojibwe and Riverwood Healthcare Center of Aitkin/McGregor.

Through the online platform, each participating community convenes teams of pharmacists, physicians, social workers, nurse care coordinators, mental health professionals and others. They review strategies used by CHI St. Gabriel’s, including reducing the inappropriate use of opioids through care coordination, addressing unmet social service needs, education and assistance for providers, proper opioid disposal and engaging resources outside the health system.

Based on six months of data, the program has helped those communities cut patient pill use by nearly 765,000 pills per year, while getting 147 patients needed care and adding 21 care providers to the ranks of those qualified to give MAT (medication-assisted treatment) therapy.

Nelson Communications gets NTCA award for digital outreach programming for seniors

Broadband Communities reports on Nelson Communications, a vendor that has worked with BBCs (Blandin Broadband Communities) in the past…

Telecommunications provider Nelson Communications Cooperative announced that they have been awarded the NTCA Smart Rural Community Collaboration Challenge Grant to connect remote seniors, using remote monitoring and socialization technology GrandCare Systems.

This grant is part of NTCA – The Rural Broadband Association’s (NTCA) initiative to highlight and support efforts that make rural communities vibrant places to live and do business. The grant promotes broadband-enabled solutions for communities and supports collaborative efforts in economic development, education, energy, health care, and public safety.

Providing Broadband Enabled Elder Care Services

Nelson Communications Cooperative, located in Durand, Wisconsin, plans to use GrandCare technology to provide broadband-enabled elder care services to seniors in rural Wisconsin. GrandCare is a large touchscreen system designed to help seniors easily stay connected with their families. It also provides telehealth, activity monitoring, and many socialization features.

“Nelson Communications is proud of our longstanding commitment to our customers and the communities we serve,” said Christy Berger, general manager of Nelson Communications Cooperative (DBA Ntec). “We also recognize that our broadband is a powerful tool for positive change and improving quality of life. In partnership with GrandCare and WSTA, we hope to demonstrate the role broadband can play to connect lonely and socially isolated senior citizens.”

Nelson Communications will leverage their connectivity and GrandCare’s communication, remote health, and activity monitoring to help engage, connect and empower seniors living in rural and remote communities.