UNM Center for Telehealth: Addressing Health Disparities in NM

• A small critically ill child presents at an emergency room in Farmington.  He and his family are able to receive expert consultation from pediatric specialists at UNM allowing appropriate treatment to begin immediately in Farmington rather than waiting for a long, and costly, transfer to UNM.

• A young college student on the Navajo reservation, the first in her family to attend college, is mentored long-distance by students and faculty at UNM as she considers a career in healthcare.

• UNM nurses connect to nurses in Lebanon in an effort at cross-cultural learning and sharing.

• A primary care physician in a remote area of NM is able to connect with expert psychiatric consultation at UNM and treat a patient in need of mental health services in the community.  The physician benefits from increasing her knowledge and clinical competence and the patient benefits from being able to receive the care he needs without traveling long distances.

• Young people across the state with Cystic Fibrosis, who cannot be in the same room together due to distance and the nature of their illness, are able to meet over video for support; helping them feel less isolated and alone.

What do all of these scenarios have in common?  Each utilizes telehealth technology to connect patients, professionals and students with the care, training and support they need, regardless of where they live. 

Read on to learn more about how telehealth is making a real difference in the communities in our state.

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As anyone who practices healthcare, or is in need of healthcare, in NM probably knows, our state suffers from a shortage of nearly every healthcare discipline.  The problem is exacerbated in rural and tribal communities which may have a difficult time attracting and retaining healthcare providers.  Shortages in healthcare workers mean individuals and families in our state frequently have difficulty obtaining appropriate care in a timely manner; sometimes having to drive hundreds of miles and wait several months for medical and mental health appointments.  This results in delayed care and increased costs in the form of gas, time off from work, etc.  Many families are simply not in a position to afford the “luxury” of taking time off and driving for hours for their care; so they simply forego it.

While there are no simple solutions to such a large and complicated issue as ensuring timely and appropriate access to healthcare for all New Mexicans, the UNM Health Sciences Center (HSC) has numerous initiatives that are making real progress towards this goal.  One such initiative is UNM’s Center for Telehealth and Cybermedicine Research (CfTH).  Since its founding in 1996, CfTH has assisted the HSC and the NM community as a whole in addressing clinical, educational and research needs through telehealth solutions.

Simply put, telehealth utilizes telecommunication to improve healthcare.  For many years, both internationally and in NM, telehealth has been used to improve patient health by providing direct patient care, consulting with and training rural healthcare providers, and educating the healthcare workforce of the future; all from long-distance.  In other words, through telehealth, we can connect specialists and experts with the patients and doctors who desperately need access to them, in real-time, no matter what the distance separating them.   

While the uses of telehealth are endless, let’s take a closer look at a few of the most common applications.

Direct Patient Care

Imagine you are a family in a remote NM community being told you will have to drive 3 hours, and wait 6 months, to see a specialist in Albuquerque.  Perhaps you do not know how you will afford the gas and the time off of work; at the same time you are quite apprehensive about your medical condition and do not want to wait 6 months to have it addressed.

Now imagine, instead, that you can access this same specialist from your local clinic in a timely manner simply by “talking” over a televideo unit.  Minimal time off of work, no long drives, and no long wait to get the care you are anxious to receive.

This is just one of the benefits of telehealth as it is being utilized throughout this state and country to provide mental health, neurological, dermatological and OB/GYN care, to name just a few.  The set-up is simple: a rural/remote clinic connects with UNM providers who offer specialties not available in that community.  Patients at these remote sites are scheduled an appointment at their local clinic, just as they normally would, but instead meet with the specialty provider via telehealth.  The patient benefits from timely care in their community and the local provider benefits from the increased training they receive from the specialist by co-treating the patient.

  Provider Consultation and Increasing Rural Provider’s Expertise

Many healthcare providers practicing in remote areas find themselves in a position of trying to care for too many patients with too few resources or services available.  No healthcare provider can address every patient condition, yet that is often what is expected of providers in remote areas.  Telehealth can be a professional lifeline to such providers, as it connects them with broader resources outside of their communities.   Through telehealth, providers can consult directly with specialists about a specific patient care issue.  They can also receive ongoing education, mentorship and case consultation about certain medical/mental health conditions.  This benefits the provider, patient and community: providers expand their clinical expertise and feel less isolated, patients benefit from the enhanced clinical care their local provider is able to deliver, and communities are more likely to retain their healthcare providers.

 Home Health Monitoring

With the proliferation of mobile devices such as smart phones, the promise of home health monitoring is quickly becoming a reality.  Such monitoring can range from tools that empower an individual to manage their health conditions to technology that sends patient data to their healthcare provider for remote monitoring.  The latter is particularly useful post-surgery or for managing chronic illnesses.  Home health monitoring of things like blood pressure, wound healing, and insulin levels helps to identify potential issues early and possibly avoid complications and costly hospitalizations.

 The Workforce of the Future

The future of healthcare in NM depends on our state’s ability to attract, train, and retrain high quality healthcare workers.  Moreover, developing a local, culturally-competent workforce keeps people in their communities, giving back to the people and places in which they are most invested.   

The applications of telehealth to workforce development and retention are limitless.  A few examples include: connecting high school and college students in remote areas to professional mentors at a distance; providing a platform for groups to communicate with and support each other internationally; and exchanging knowledge and expertise between local communities and academic health centers. 

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While telehealth as a concept is not new, we are on the precipice of a world of new and innovative options for linking patients, communities, and healthcare providers in a global network of mutually supportive, healthy and thriving communities.  We at the UNM Center for Telehealth continue to take a lead in creating new opportunities for enhanced healthcare throughout our state and would be glad to speak with you about the possibilities.