Wednesday, February 10, 2010

Lessons from the Snow

The past five days in Washington, DC have been a test for those who live in the nation’s capitol. Twenty inches of snow last weekend have been followed by an additional 15 inches of snow and ice this week. Roads were clogged. Snow overwhelmed the region’s snow removal equipment. Mass transit virtually stopped. For days schools, local businesses and even the federal government closed.

Many residents were trapped in their homes, far from the nearest store or major roadway and further still from doctors' offices and health professionals who themselves were unable to reach their office. More than one parent was faced with a child who suddenly came down with a fever and no way to get to a doctor to see if it was something more serious. More than one chronically ill patient became just a bit more worried that the visiting nurse was now out of reach.

But what was a temporary inconvenience for a week is a permanent problem for thousands of people who are homebound or live in neighborhoods without adequate mass transit.

Some say that telemedicine, the provision of health services using telecommunications, is only for the most rural and remote communities. For 40 years almost all federal funds for telemedicine have been targeted only for rural areas. Congress and the federal Center for Medicare and Medicaid Services have allowed reimbursement for remote health care to rural hospitals and clinics but nothing for the 77 percent of Americans living in urban areas. Even further, nothing is available to support remote monitoring for anyone at home, leaving the homebound and chronically ill to depend on a visiting nurse or to trek to the nearest health professional.

New technologies allow access to health professionals via home computers and cell phones. Sending vital signs, getting answers and even reassurance from a health professional can now be only a call away. But none of this will be available unless insurers pay for such services for their covered populations, no matter where or when they are needed.

Isolation is not always measured in miles and healthcare is not only needed in the hospital.