More NRTRC Annual Conference Notes

In addition to the presentation by our team going extremely well, there were many attendees discussing what role telehealth can and does play in behavioral health. It was encouraging to realize how long the concept of telehealth has been in practice and to see how its grown as technological advances have grown to support it. There are some thoughts on how this might implemented into our current program; early stages as of yet, but certainly something to look into.

 

FUTURE GROWTH

We continue to investigate partnering with the larger care organizations in our area to see where this program might fit to support their patients. Identifying the population and how to tap into is remains a high priority. The idea behind it always being continuity of care, patient engagement and supporting patients in a way that will encourage their engagement.

Observations

What are the staffing needs for a program like this? Based on best practices to date, this largely depends upon the number of patients brought onto the program at one time. The ideal manageable number for our locations and patient population 1 RN for every 75-100 patients. Ideally during the first year of implementation there should be at least one fulltime employee dedicated to the program then once it is in place 1 RN with 1 Per Diem Nurse seems to be sufficient.

Consent Form Language Translation

With a relatively high population of patients in this region who are English language learners, or otherwise not fluent in English, the unavailability of translated patient consent forms could be problematic.  The first language of many patients in Central Oregon is Spanish, however, the site has not yet received consent forms in any language other than English. 

In attempt to circumvent this issue, the Mosaic Medical language specialist has translated a portion of the necessary forms, and the translated draft is currently under review by Mosaic’s document review committee.  The specialist, however, is not in a position to translate all necessary documents in their entirety for the following reasons:

·      Ethical question of placing responsibility on medical interpreters to translate legal documents, as they may not be properly trained in this language

·      Difficulty of translating a technical English document, maintaining sensitivity to reading levels and nuances of language

Thus far, only one patient has been unable to independently read and sign the consent form due to it’s being unavailable in Spanish.  In this case, a translator was unavailable to accompany the RN and TCA to the installation.  The necessitation of a translator during home installations can pose a burden for the clinic, and may slow the process of delivering remote care to patients.

Possible resolutions of the consent form translation predicament will be discussed during the next meeting of COTN and RCCHC.

Patient Referral

During a recent installation, a patient inquired as to whether their spouse could use the blood pressure cuff newly installed in their home to monitor his own blood pressure.

Although the answer was no, this is one example of a positive referral being made by a program participant due to their own involvement with and enthusiasm regarding the possibilities of remote monitoring.  It has not yet been determined whether this patient's spouse will be recommended for the program by their PCP, but this demonstrates the value that some patients place on being able to monitor their health independently.

Transmission Difficulties

The new equipment that has replaced older PODs has been a step forward in remote patient monitoring in the region.  However, equipment challenges persist.  The most recent encounter involved an installation in a home with a roof made of metal.  It seemed that the metal roofing of the home, which extended into the eaves, caused difficulties with the PODs ability to relay a signal.  Some patience combined with patient flexibility aided in testing the POD in different locations around the home, resulting, eventually, in a successful transmission.  This issue could be potentially troublesome due to the unanticipated amount of extra time that the installation took.       

Roanoke-Chowan Community Health Center is making the news. Here is a two-part article about their North-Carolina-based remote monitoring program and some information about the Central Oregon project in the mix.

Part 1 is available at this location.

Part 2 is available at This link.

Stay tuned to this blog for further information as the project develops.

Welcome to the Central Oregon Telehealth Network!

This blog has been established to track the process of starting and exciting project: Connecting Remote Monitoring facilities in North Carolina and Oregon, a coast-to-coast Telehealth project.

The Roanoke-Chowan Community Health Center is facilitating the startup of remote monitoring of chroncally ill patients in central Oregon and this blog has been designed to track the impressions, challenges, victories and solutions experienced by the staff in this exciting effort.

The blog and analysis of the project are being conducted by the Mid-Atlantic Telehealth Resource Center (MATRC) and the Northwest Regional Telehealth Resource Center (NRTRC). The Telehealth Resource Centers are part of a nationwide group of centers aimed at expanding health care to underserved areas through Telehealth services. For more information on the TRCs, visit the National TRC website, For information on MATRC, click on this link; and for information on NRTRC, click here.

The COTN Experience blog will post impressions from the participants in the project, both providers and patients. It will also contain observations from the TRC staff who are monitoring the project and from project administrators. We encourage you to track this site as the project grows.