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Posted: June 29, 2017

Laura Douglass/ThePilot.com

In the evolving world where healthcare and modern technology merge, managing patient needs is not always accomplished in doctors offices.

These days it can also mean an e-visit. Bedside manner has gone high tech.

The terms telemedicine and telehealth are both used to describe the clinical application of technology to enhance healthcare delivery. It is used across multiple disciplines — including dentistry, counseling, physical therapy and in home health — and has further expanded opportunities for patient and also professional education.

Convenience is obviously one of the biggest benefits of telehealth, but working with patients through a video consultation can also free up time for doctors to attend to those with more serious conditions. A report by a medical consulting firm in 2015 found that one-fifth of all urgent primary care visits could have been conducted through a virtual visit with a medical professional.

But one of the primary advantages, especially in a state like North Carolina which has wide swaths of rural territory, is that e-visits and e-therapy can deliver specialist services where otherwise they may not be readily available.

FirstHealth of the Carolinas introduced telemedicine technology about a decade ago with remote home monitoring of patients. Since then it has evolved to include telepsych, telestroke, teleneurology, and telecode care. In addition, other healthcare providers in the area have also stepped up their efforts to utilize telehealth programs to better serve their patients.

Daymark Recovery Services, which has a center in Pinehurst and 30 sister clinics spread across the state, was one of the earliest adopters of telemedicine practice. The 18-year old organization was initially a spin-off from the Davidson County and Piedmont Area Mental Health Programs.

“As we grew into more rural areas we found it difficult to find psychiatric coverage for the more rural clinics,” said Daymark President and CEO Billy West.

Daymark initially started a pilot telemedicine program linking its Concord and Winston-Salem offices.

“This expanded to where we have shortages of doctors,” West said. “These services are mainly psychiatric evaluations and follow up medications checks.”

However, once Daymark began offering walk-in service hours at its clinics, West said they had an explosion of patients and telemedicine helped to absorb that demand.

“We had previously operated on an appointment driven system,” he said. “But we noticed so many of our patients were indigent, had nowhere to go and were using emergency rooms if they could not get an immediate appointment. This doesn’t mean you necessarily need to see a doctor but you do need to see a mental health professional the same day you request one.

“This made our patient population explode system-wide.  Consequently, it increased the need for psychiatric time and need for telemedicine.”

Locally, Daymark’s center in Moore County provided 812 services to 311 patients over the previous 12 months. The telemedicine component is incorporated into the clinic’s overall services but its impact is more significantly felt in the surrounding counties.

“In rural areas, and in the Sandhills especially, you are are looking at rural counties where it can be difficult to reach a doctor for face-to-face for psychiatric services for children and adults,” said Jerry Earnhardt, Daymark’s Sandhills area operations director. “This technology has become pretty well adopted across all of our clinics.”

The telemed machine at the clinic in Pinehurst includes a smart television with a camera, and the facility also has the capability to use the technology from laptop computers. The technology is most often used for training purposes, clinical supervision, and client assessments.

“It is similar to Skype but all of the interactions are on a secured line to comply with HIPPA,” said Gary Kaufman, director of Daymark’s Moore County Center.

That is, communication moves along internal connections from secure point to secure point to meet federal privacy requirements.

“We are not using wireless lines that are vulnerable to being hacked,” Earnhardt said. “We use hard line fiber optics. This is a closed system.”

Another important factor to consider is the overall cost. West said telemedicine is not a cheap alternative: In fact, the service can actually be more expensive for a clinic.

“If done effectively and safely it requires an MD to provide one service, an RN and/or very professional staff on the end where the patient is, immediate access to electronic records and e-prescribing,” West said. “Telemedicine though is a medium where people can have access to care where they would have not otherwise had the ability to be seen by a specialist.”

Article Reference: The Long-Distance Doctor is In