The Promise of Technology: Telemedicine Brings Specialty Health Care to Rural Areas
Telemedicine is an innovative new model that helps to close the gap in rural health disparities. By bringing high quality care to people in need in rural and underserved areas, telemedicine holds much promise. In New Mexico, Dr. Sanjeev Arora of Project ECHO is working to bring coordinated care to patients who lack the resources to travel long distances.
Project ECHO (Extension For Community Healthcare Outcomes) at the University of New Mexico is an innovative telemedicine clinic. It uses technology to serve rural and underserved communities. Specialists share their expertise to help far-off patients living with chronic diseases.
Recently, I was invited to observe a teleconference. I was able to see how technology and partnerships can extend the reach of specialized health care.
The clinic takes place in a meeting room with two large screen televisions. One screen is split into smaller screens, showing the faces of providers calling in from rural and underserved areas. The room is filled with the Project ECHO team of nurses, mental health specialists and the team’s leader, Hepatitis C Specialist Dr. Sanjeev Arora.
One at a time, health care providers from remote clinics join the teleconference. Dr. Arora greets everyone by name, and the environment is warm and welcoming. The Project ECHO team is prepared with copies of the medical records of all co-managed patients. The remote providers take turns presenting patient medical histories and current status. It is a respectful, cooperative system. Each participant brings a unique perspective to the table.
I witness the power of the Project ECHO model in action as the teleconference participants communicate, sharing critical and often life-saving information. It is a form of team-based problem solving. The Project extends the knowledge of specialists, while also valuing local providers’ community connections. The patients are people without resources to travel long distances, and the telemedicine model allows patients to remain employed in their communities. Dr. Arora believes that telemedicine can help provide better health care for people who are homeless in rural areas.
While the patient is not present for the teleconference, each one is viewed as a whole person when providers discuss treatment needs and consider all aspects of the patient’s life. Is the patient a good candidate for treatment? What resources are available for managing mental health and substance use issues? A well-organized system of collaboration provides high quality care, in addition to learning opportunities for community health care providers.
Dr. Arora is the conductor of a carefully organized symphony to relieve human suffering. His approach to sharing his specialized knowledge stems from his own background. “I grew up in India and saw many people without access to health care. I have always known that to whom more is given, more is required,” says Dr. Arora. “Is there something I can do to help a much larger number of patients than I can see myself?”
In New Mexico, Project ECHO is working closely with Albuquerque Healthcare for the Homeless to provide access to Buprenorphine for opioid addiction treatment. Through the partnership, more than 115 doctors across New Mexico have been certified to prescribe Buprenorphine. Previously, only thirty doctors in the entire state were certified.
Miriam Komaromy, an addictions specialist who has experience working with people who are homeless leads the project. “In a subset of patients where homelessness is related to substance use and mental health issues, effective treatment with Buprenorphine can help move people out of homelessness and into employment.”
Dr. Arora travels frequently to share his knowledge and expand the Project ECHO model with new partners. Project ECHO is working with the University of Washington and Indian Health Services in Oklahoma to replicate the model to treat Hepatitis C and chronic pain. The Project is also working with the government of India to pilot the model for HIV treatment.
Dr. Arora believes that the model has the power to extend access to quality health care to many. He shares, “the Project ECHO model of sharing the knowledge of specialists to provide community healthcare support and education is a replicable model that has both the vision and the practical tools to effect massive change.”
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