You can now visit your doctor and get treatment without leaving your home (or bed). Instead, patients can use their computer or phone for a telemedicine appointment.

“Prior to COVID, telehealth was placed in a box and that box was very limited,” said Chad Hunter, project manager of telehealth for UPMC in North Central Pennsylvania, during a presentation at Tri-County Rural Electric Cooperative’s meeting in Wellsboro earlier this month. “Now, we have to look at healthcare in a different way than in the past. Telehealth is a great opportunity to maximize the provider’s time and your time, because your time is valuable too.”

Hunter’s presentation included a live demonstration of a typical telehealth video call with Dr. Christopher Domarew, internal medicine physician with UPMC, as the call’s doctor. Hunter said such calls are impossible without a speedy and reliable internet connection, which is where Tri-County comes in.

The first electric cooperative in Pennsylvania to launch a fiber-to-the-home internet project, Tri-County has been working to bring highspeed broadband internet to parts of Tioga, Potter, Bradford and Lycoming counties since 2019. To date, Tri-County has installed 500 miles of fiber optic serving more than 700 customers, with another 600 miles planned this year.

“Everything that you do, whether it’s buying a car, shopping for a home or telemedicine, it brings technology to the forefront,” said Kevin Brownlee, Tri-County’s president and CEO, who took his new position in March. “The things you’re able to do with that and the quality of life it creates falls right in line with the mission of the cooperative of improving the lives of our members.”

Hunter said telehealth in particular has been improving people’s lives since the invention of the telephone in 1876 when people could call a doctor. He said telehealth got a boost with the start of the American Telehealth Association in 1983 and the first patient remotely defibrillated in 1989.

“The pads were placed on the patient’s chest and activated through a remote sensor from 100 miles away,” said Hunter. “The patient was resuscitated with no doctor, no room nurse in the room. That’s pretty amazing.”

Today, UPMC defines telehealth as “the use of medical information exchanged from one site to another via electronic communications to improve patient’s health status,” which takes several forms.

An Asynchronous – Provider to Provider telehealth event means your doctor confers with another doctor or specialist, and Asynchronous – Patient to Provider is when a patient sends a photo or video to their doctor, who can inspect it and follow up as soon as they’re free.

“Synchronous – Provider to Patient is like what we just saw,” said Hunter of the demonstration at the meeting. “That’s where you’re sitting at your house and you say, ‘I’m an hour from the hospital, I’m an hour from my doctor, I feel so awful. I don’t want to leave my home.’ That’s what we saw a lot of when COVID hit. Everybody was rightly concerned about coming into the hospitals or coming into contact with someone who might be sick.”

Synchronous – Provider to Provider/Patient involves a patient seeing their primary care doctor, but also interacting with a specialist based elsewhere, usually through video chat. Hunter said this allows a patient to be with a familiar face, their doctor, who can help interpret language used by a specialist and help develop a care plan going forward.

“And the last approach is Remote Patient Monitoring,” said Hunter. “Whether it’s a blood pressure cuff, or a diabetic checking their blood sugar, your equipment is hooked up to the internet that takes the information and sends it to your doctor in real time. It doesn’t require you to do anything other than take the reading as you normally would.”

Hunter said COVID changed the way patients, healthcare providers and insurance companies view telehealth. While it wasn’t routinely used by many people, especially in smaller rural areas, the pandemic made it a necessity.

“Prior to COVID, in the state of Pennsylvania, there were less than 10,000 telehealth visits a month. That’s out of almost 13 million people in the entire state. When COVID hit, just in our region we had 10,000 visits a month,” he said.

Due to that shift, federal legislation now requires insurance companies to charge the same for telehealth visits as in-office visits. Hunter said before, telehealth was viewed as a privilege by some providers and insurance companies and was therefore charged at a premium.

UPMC’s response to the increased need for telehealth over the past year included ramping up its spending on tools and technology to improve access and quality, increasing the number of providers who offer it and adding new features for patients on the MyUPMC app.

“Getting the internet connection needed can be very, very difficult,” Hunter said of the rural population UPMC serves locally. “The populations who need help the most, are usually the populations with the least access to it.”

For information about telehealth at UPMC, visit www.upmc.com/healthcare-professionals/physicians/telemedicine. For information about Tri-County’s broadband project, www.tri-countyrec.com.

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