The Institute of Medicine (IOM) HRSA sponsored workshop on the “Role of Telehealth in an Evolving Health Care Environment” was held August 8-9, 2012 at the National Academy of Sciences in Washington D.C. Karen S. Rheuban, M.D. serving as Chair of the Workshop Planning Committee, a Professor of Pediatrics (cardiology), and the Director of the University of Virginia Center for Telehealth, introduced keynoter Mary Wakefield PhD, RN, Administrator for HRSA.
As a leading rural healthcare advocate and a native of North Dakota, Dr. Wakefield brings much expertise to the field of providing rural healthcare from her position as the Associate Dean for Rural Health at the University of North Dakota’s School of Medicine and Health Sciences before joining HRSA in 2009.
Dr. Wakefield wants to see new opportunities for telehealth technologies to be used effectively and become a key player in the medical and health fields. However, there are challenges that lie ahead especially in rural areas. For example:
- The rural population is spread across 80 percent of the country side which means that the technology has to be widely dispersed in order to connect rural residents to healthcare
- Rural communities tend to be older, residents have lower incomes, and higher rates of certain chronic diseases which can create additional barriers
- There are difficulties in attracting not only physicians but also pharmacists in rural communities
- Hospitals in rural areas are generally small and operating on a thin margin
As Dr Wakefield pointed out the Affordable Care Act is going to produce special tools and benefits to help expand insurance coverage in rural areas, develop team-based centered care utilizing telehealth, help address health disparities in rural and minority populations, and expand rural community health structures.
HHS is involved in several telehealth initiatives linked to all aspects of healthcare. For example, during the recent AIDS International Conference, Secretary Sebelius announced a series of innovative public-private partnerships in the fight against the HIV/AIDS epidemic where telehealth can play an important role.
Dr. Wakefield discussed the “UCARE4LIFE program where HHS will partner with the MAC AIDS Fund to launch a mobile texting pilot program to help patients get important reminders and tips for managing their HIV/AIDS health issues. The program will develop a message library to deliver timely phone text reminders in English and Spanish to remind HIV-positive individuals about their medical appointments and when to take their medications. This two-year project will focus on the southern states where the epidemic is rising fast among youth.
Dr Wakefield pointed out that the White House Rural Council is working to help veterans in rural areas. The goal is to help create jobs, increase the flow of capital to rural areas, promote innovations, and expand digital and physical networks in rural communities.
Dr. Wakefield mentioned several other efforts to help the rural population. For example, HRSA’s Office of Rural Health Policy awards grants through the Flex Rural Veterans Health Access Program to provide mental health services and other services to veterans and other residents of rural areas.
The state of Montana with a very rural population received an award through the Flex program that now reaches out to more than 30,000 veterans in the most rural areas of the state to deliver high quality mental health services.
In addition, the Telehealth Network Grant Program funds projects that demonstrate the use of telehealth networks to improve healthcare services for underserved populations in urban, rural, and frontier populations.
High on the agenda are collaborative efforts to involve the federal agencies in a plan to move telehealth forward. To achieve this goal, the “FedTel: Cross-Federal Work Group on Telehealth” has been established to identify possible collaboration mechanisms and share lessons learned across multiple agencies. The agencies participating include NIH, HRSA, AHRQ, CDC, CMS, FDA, and IHS.
As Dr Wakefield noted, HRSA is proud of their Telehealth Resource Centers so that individuals are able to learn about new developments to help them achieve the most effective use of telehealth. This program is funded by HRSA’s Office for the Advancement of Telehealth and maintains eleven Regional TRCs and one Technology Assessment Center.
Other items on HRSA’s agenda include addressing the licensure portability issue. This year, HRSA posted an announcement soliciting applications for the Licensure Portability Grant Program (LPGP). The purpose of this grant program is to support State professional licensing boards to carry out programs so that licensing boards in various states can develop and implement state policies that will reduce statutory and regulatory barriers to telemedicine.
To sum up, Dr. Wakefield said, “To provide more effective and better quality healthcare, we have to go to a new place and to do this, we need to develop new technologies, new ways of thinking, and at the same time, maximize resources. Telehealth can lead the way by making the best and latest telehealth resources available to serve all Americans.”
Go to www.iom.edu/Activities/HumanServices?Telehealth/2012-AUG-08.aspx for more details on the meeting.