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Access to healthcare and telemedicine

Telemedicine is a important and growing method of proving health care to under-severed areas.
Telemedicine is a important and growing method of proving health care to under-severed areas. Getty Images/iStockphoto

Mercer University School of Medicine

While medical care has advanced tremendously in the past 50 years, the delivery of that care has been concentrated in metropolitan areas. Even in cities, many people have problems accessing that care. Rural areas face an even greater challenge with few physicians and fewer hospitals.

With this recognition, local civic leaders and leaders from Mercer University founded the School of Medicine over 35 years ago. Our school now has three campuses and sends students to small towns to learn about rural health care during the four years of their education. The value of a rural health network cannot be overstated. Access to health care improves quality of life and enhances economic development.

Even still, many graduates continue their training in large city hospitals, a model of education essentially unchanged over the last 100 years. Following medical school, these graduates choose to live in the large cities where they trained. Young, recently trained doctors often find moving to small towns daunting. They realize that the skills needed to sustain effective practice in these areas are complex and often involve conditions they have never seen and do not have the experience to address.

One proposed solution to the poor distribution of our medical workforce is the use of tele-health. Telemedicine is simply the practice of medicine using technology. In Georgia, telemedicine is held to the same standard as an in-person visit to a physician.

For over 20 years, these encounters have occurred between a generalist physician (or an advanced level nurse or physician’s assistant) and a specialist colleague far away, via a secure encrypted video connection. This service allows a patient to get an opinion from an expert without travel and with the benefit of a hands-on examination provided by the physician who is with the patient.

Working together effective, efficient specialty care can be provided. An example of this is Tele-stroke care. Stroke neurologists in urban centers work with primary care physicians across Georgia to oversee the emergent intervention and treatment of stroke patients many times daily. Often this intervention prevents severe debility and death.

Telemedicine is progressing rapidly and now provides for the thorough examination of patients by physicians through technology. Doctors have the ability to examine ears, noses and throats, listen to heart and lung sounds and observe skin color and integrity very accurately. Someday soon, technology may progress to a point that allows touch and palpation.

Georgia has long led the nation in telehealth. Georgia laws require insurers to pay for telehealth services. Through work done by Mercer medical school, ambulances may now serve as presentation sites for patients. One hopes that this designation will decrease the need for inappropriate utilization of emergency rooms while allowing patients to receive quality care in the community.

We talk a lot about teamwork now in medicine, and reducing medical errors by teaching the importance of teamwork. Building a network of rural doctors (and other practitioners in health care) that can easily and reliably connect to colleagues in specialized fields of medicine for complex and puzzling cases is one way of keeping medical graduates in less populous areas. Making resources (such as consultants) more available to rural health care workers makes these towns more attractive. Our mission, to place graduates in areas that need more doctors, will be enhanced by educating students on the uses of telehealth, and encouraging the support of this modality in delivering quality care to the citizens of our state who have accessibility issues.

Dr. W. Patrick Roche III is an associate professor in the Department of Family Medicine at Mercer University medical school. Dr. Jean Sumner is dean of the medical school.

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