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View Diary: The Importance of Internet to a Rural Community (54 comments)

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  •  It has medical implications, too. (16+ / 0-)

    10 years ago when I worked in a teaching hospital in mid Missouri, telemedicine was just being explored.  One of the doctors I worked for held telemedicine visits with many of his isolated rural patients with diseases that required close monitoring.  These patients would go into a local doctor's office where that doctor could do some routine checks and discuss those online via webcam with my doctor/boss.  Both the rural doctor and patient got to interact with my doctor/boss and they could all make crucial decisions together without the patient having to travel over a hundred+ miles.  But my doctor/boss had to throw many fits to make it possible to do this, he had to take on asshole companies like AT&T to get it done.  

    Some of these patients were elderly or in rough shape.  They had thyroid diseases diabetes or other metabolic illnesses that for one reason or another required close monitoring and a level of expertise that the rural doctor couldn't provide, but the patient might not be up to making that horrific trip or just couldn't afford to make it.  So telemedicine can be a cost-saving measure for both the patient and the doctor.  Since everyone is screaming about bringing down health care costs, how much money could be saved if you could see your specialist via computer and include your local doctor in the process?

    I've had a bug up my butt since before NN in Pittsburgh about this whole internet in the sticks thing.  I think it's shameful that you can't get online in little towns or remote places.  Hell, the thing that put the bug up my butt was not being able to get reliable access to the internet from a town that's only 10 miles away from a major college town, a little town that has two snooty private colleges there already.  You can't tell me those expensive little colleges can't get online.  So why can't the unwashed masses?  It's ridiculous.  I had to make threats to get access for my son and his family, and even then it was inadequate service at a totally unreasonable price.  Since then they've gotten a better provider in that town, but it doesn't help all those other little boondocks out there in the hills.

    It's shameful, I tell you.

    "The world breaks everyone, and afterward, some are strong at the broken places." Ernest Hemingway

    by Got a Grip on Mon Apr 25, 2011 at 04:52:57 PM PDT

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    •  telemedicine is a huge potential boon (9+ / 0-)

      for lowering cost to both patient and system.

      I grew up in LA.. and so at worst, a specialist might be inconvenient and an hour away.

      Here on the north coast, there are people for whom the nearest specialist is a 4 hour drive away. I don't just mean for some super-specialty either. It is relatively common for people who live in Eureka to attend medical appointments in Sacramento. It's a pretty drive once in a while, but completely devastating if it's something you have to do regularly. If you're still working, the travel time will kill you; if you're not still working, you may not be healthy enough to do that much time in a car... not to mention you may need a driver.

      Greater Eureka is remote, but it's not tiny. It has a CSU campus and significant population.

      Being able to work with the patient's primary care doc and a teleconference not only has the benefit of allowing a specialist to serve a larger area, not only has the benefit of saving the patient a lot of time and money, but also gets the whole medical team on the same page. It is bizarrely uncommon to have two doctors and a patient conferring together - which, if you think of it, is absurd. Everyone could benefit from this kind of service.

      Fry, don't be a hero! It's not covered by our health plan!

      by elfling on Mon Apr 25, 2011 at 06:02:08 PM PDT

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      •  Oh, yes, telemedicine can be a wonderful thing. (8+ / 0-)

        It really improves patient care.  As you say, having the small town doctor and the specialist both conferring with the patient directly involved makes a huge difference in the quality of care the patient receives.  And especially some of the patients we dealt with who sometimes have rare disorders that are difficult to treat or resistant to medications, or a patient that has medication resistance or sensitivity where tiny changes in either the quantity or timing of medication can have profound effects.  And then there were the older patients who often didn't understand exactly what they were supposed to do when they got home after an exhausting trip so far away.  Being able to spare them that kind of stress and having their home town doc there to get first-hand instruction and then spend time helping the patient was a huge advantage.  Without the telemedicine it was a nightmare trying to connect those two doctors by phone for even the most brief consultations, and then you didn't have the patient involved with their own care.

        All of these things should be standard practice.  It would save a vast amount of money, and since that's what matters to the political class and the insurance companies, you'd think they'd be lobbying for such changes.  I know how frustrating it was for my boss/doctor trying to make that connection happen, but it was so worth the effort when he finally had success.

        "The world breaks everyone, and afterward, some are strong at the broken places." Ernest Hemingway

        by Got a Grip on Mon Apr 25, 2011 at 08:48:27 PM PDT

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        •  There is a federal program called e-rate (5+ / 0-)
          Recommended by:
          chimene, Matt Z, Oh Mary Oh, ybruti, Got a Grip

          that gives grants for high speed internet for schools and medical facilities. We need more of this.

          I'm pleased that the FCC recently announced a rule change that allows schools to make this broadband available to community members when school is out of session. But still, what we really need is for this to be an impetus for the telecom carriers to make that bandwidth then available to the whole community. There seems to be some movement in this direction, with a recognition that it benefits students to be able to access the internet from home as well.

          Fry, don't be a hero! It's not covered by our health plan!

          by elfling on Mon Apr 25, 2011 at 10:45:09 PM PDT

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