Telemedicine takes off in Northern Michigan

Telemedicine isn’t new, but its value to northern Michigan’s healthcare is growing “by the day,” said Laura Glenn, vice president of physician network for Munson Healthcare.

In fact, Munson Healthcare’s nine hospitals have been ramping up the focus on telemedicine “by the day, by the week, by the month,” she said.

“We really see digital health as its own service line, but it can also support all aspects of care across the system,” she said. “We’re trying to make sure that, as we mature and evolve our program, it’s able to do just that.”

That growing emphasis on remote care possibilities is particularly crucial for a hospital system like Munson, because of the rural communities each hospital serves.

“One element of our current strategic plan for Munson Healthcare is to look at ways that we can use telemedicine beyond what we’re doing today to better meet the needs of our rural community,” Glenn said. “We recognize that, particularly given our rural geography and the communities that we serve, we need to be thinking about additional ways that we can leverage telemedicine.”

Defined as the remote provision of healthcare services via telecommunications technologies, telemedicine is one of the largest trends in the healthcare industry. It’s also a game-changer for northern Michigan, where Munson Healthcare and other providers are going out of their way to make remote care more accessible to their patients.

Wolff

Jesse Wolff, who leads the HealthSpark program for Traverse City tech incubator 20Fathoms, says the draw of telemedicine for rural areas often clashes with the lack of high-speed broadband access and a lack of patient awareness or trust.

The challenge, Wolff notes, is that rural patients have more to gain from telemedicine than patients who live near metropolitan hospital systems. Long travel distances to healthcare providers, limited public transportation options, the impact of bad weather, and shortage of physicians (particularly in specialty areas) are all problems that rural health systems face. All of them can be partially or entirely addressed through the implementation of telemedicine, he said.

He notes that telemedicine in general is on the rise: In 2020, 85% of hospitals have “some kind of telehealth platform,” up from just 35% in 2010. Within a few years, Wolff expects that telemedicine will be very nearly ubiquitous across American hospital systems.

“There’s this adoption and utilization challenge in rural communities,” Wolff said. “One of the trends right now in telemedicine is about educating patients on how to use it, why to trust it, and how we can get those utilization rates higher because of all the benefits that come from rural use.”

Glenn

Glenn notes that Munson has been leveraging telemedicine in some of its service areas for years. For instance, Munson Home Health – which provides home healthcare services to patients throughout 24 northern Michigan communities – provides each patient with a tablet device for remote monitoring and consultation.

Each morning, the device asks patients a range of questions about their health, ranging from general (how they are feeling) to specific (readings for heart rate, blood pressure, and weight). The responses are delivered via secure connection to a Munson Home Health nurse, who can review the information and suggest an in-person appointment if anything looks out of the ordinary.

Patients can also use their devices to interface with providers via video chat, or to access informational resources about their health conditions, treatment paths or medications. Glenn says these telemedicine components have been part of Munson Home Health for over two years and are at this point “fairly mature.”

Elsewhere, Munson’s forays into telemedicine are a bit newer. For example, telemedicine has enabled Munson’s Dr. June Murphy – an obstetrician-gynecologist – to conduct remote patient visits at multiple system hospitals. Murphy can interpret maternal ultrasounds from throughout the Munson network or offer support to regional OB services, all without traveling to those sites.

Glenn says that Munson is also leveraging telemedicine to “support psychiatric access issues that we have in our regional communities.” Through this program, patients can visit primary care offices in towns like Cadillac and Kalkaska for weekly remote consultations with Munson psychiatrists.

In addition to these types of ongoing telemedicine arrangements, Munson will occasionally use the option of remote care as a contingency plan of sorts. Munson has a medical oncologist who regularly travels to areas such as Manistee, Grayling, Charlevoix and Cadillac to see patients. In situations where inclement weather makes getting to those sites dangerous or impossible, Munson uses telemedicine to allow for virtual visits rather than canceling the appointments and delaying care for patients.

Across the board, telemedicine is increasing access to care for patients throughout northern Michigan – particularly those in difficult-to-reach communities. It’s not just areas that fall into Munson’s radius, either. Wolff recently worked with the head of the Mackinac Island Community Foundation, who asked him for advice on how to introduce mental and behavioral health offerings to island residents on a remote care basis.

“It’s not like it’s easy for someone from Mackinac Island to head off for an appointment on the mainland in the middle of January,” Wolff said. “So I connected them with Pine Rest, which is a behavioral health clinic in Traverse City that has nine telemedicine-licensed counselors. Pine Rest can deploy those counselors into communities such as Mackinac Island.”

While the benefits of telemedicine are substantial, it’s actually been a long journey to get to this point. Even though smartphones, tablets, and video chat technologies have all been mainstream-accessible for more than a decade, telemedicine is just now hitting its stride. Why the delay? Insurance.

“One of the trends right now is that reimbursement for telemedicine is getting better and better,” Wolff told the Traverse City Business News. “The private insurance companies have been covering telehealth for several years, but the government insurance programs – Medicare and Medicaid – had been a little slower to reimburse for broad uses of telemedicine.”

Old restrictions have been lifted, said Wolff.

“For example, if you were a patient, you couldn’t just access telehealth in your home and make a claim for it,” he said. “You had to go to an approved facility, like a community health center, and have a trained facilitator sit in on the session with you. That defeated the purpose somewhat. Now, Medicare and Medicaid are being much more progressive, so it’s becoming a much broader reimbursement policy.”

Glenn and Wolff both see the growth of telemedicine as a good thing for everyone. Wolff suggests that allowing claims on these services actually helps insurance providers in the long run, because it leads to healthier patients and fewer expensive claims.

Hospitals and care providers, meanwhile, benefit by being able to provide higher-quality ongoing care to patients, minimize travel time for healthcare specialists, and cut down on expensive appointment cancellations or weather-related no-shows. Finally, patients benefit by getting more up-to-the-minute care from their physicians, avoiding needless and costly emergency room visits and staying healthier in general.

In response, Munson is expanding its telemedicine offerings. In February, the healthcare system hired Chelsea Szafranski as assistant director of digital health. Glenn says the new appointment will not only enable Munson to expand its offerings, but also improve the areas where telemedicine is already being utilized.

“What we identified is that we are doing a lot with telehealth already,” Glenn said. “We need somebody who is going to make sure the work we are doing is coordinated, who can help us develop those additional use cases, and who can help accelerate our adoption of telehealth into the future. We see this as an area of continued expansion in order to better meet the needs of our patients. Chelsea’s role is to lead what exists today, but also to help build into the future.”

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