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Haley Sharon and Wendy Barnhart

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May 7, 2013
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Telehealth offers quality care without leaving the area

Telehealth is like seeing a specialist face to face without the wait time or the drive.

With all the advancements in technology and our modern healthcare system converting more and more to the use of Electronic Medical Records (EMR) and Electronic Health Records (EHR), it is only natural for patient care to adapt to and make use of these changes for more options and improved health outcomes for our patients.

For people who live in our beautiful rural environment and need medical specialty care, it can be difficult, if not impossible, to access these specialists due to lack of local availability, transportation problems, insurance issues and even physical inability to drive long distances.

The Sierra Family Medical Clinic off Tyler Foote Road, above Nevada City, has been addressing these concerns for more than 10 years with the use of Telehealth as a means to get its patients much needed consultations with specialists. This most exciting form of Telehealth connects patients in their primary care physician’s office with a specialist for a real-time consultation through the use of tele-video communication devices using high-speed Internet circuits. These specialists are sometimes as far away as Southern California but can be in another state. Patients who have found it near-impossible to access specialty care consultations can see a specialist from the comfort of their primary care physician’s office.

Depending upon the speciality, there are two options available for a Telehealth visit.

In the first live video, the patient and specialist are in their respective offices seeing each other over a video monitor, the consultation occurring face to face in real time as with any regular medical appointment.

The second option, known as Store and Forward, can involve a combination of real time face-to-face consultation and the use of still or motion photography, accomplished through the use of a special tele-exam camera (wonderful for dermatology and rheumatology concerns, as well as others).

With this option, a qualified staff member is involved and takes pictures or video under the direction of the specialist. These images are saved and sent via secure messaging system to the specialist for further review. In situations where a specialist may be scheduled far into the future, this option helps access the specialist’s impressions sooner as the images can be viewed by the specialist between regularly scheduled patient visits rather than having to wait for a scheduled appointment.

The Sierra Family Medical Clinic’s Telehealth site coordinator is frequently able to get patients who have difficulty accessing specialists, due to insurance and transportation issues, scheduled with a specialist using the Telehealth model within a couple of weeks and sometimes sooner. The referral process is much the same as for a referral for an in-person consultation. Records pertaining to the specific patient’s needs, including a history of the condition and treatments tried to date, are sent to the specialty practice in advance so the specialist can be prepared.

On the day of the appointment, the patient is asked to arrive 15 minutes early for some minimal paperwork and to have their vitals recorded and sent to the specialist.

The Telehealth site coordinator has the room and equipment set up and turned on and introduces the patient and any involved family members to the specialist.

Depending on the specialist’s requirements, the site coordinator either remains in the room to assist the specialist and patient or leaves the patient with the specialist for discussion between the two.

Generally, during the final 15 minutes of the consultation, the patient’s primary care provider joins the patient and specialist to review treatment options and decisions and to discuss follow-up needs. Initial consultations can vary from 15 minutes to an hour depending upon the specialty and the level of complexity of patient needs.

Thanks to this consultation process, patients receive much-needed care, which may not have been available to them previously, in a timely and effective manner.

Haley Sharon is the Telehealth site coordinator and Wendy Barnhart is the operations/compliance officer at Sierra Family Medical Clinic on Tyler Foote Road in Nevada City.

This most exciting form of Telehealth connects patients in their primary care physician’s office with a specialist for a real-time consultation through the use of tele-video communication devices using high speed Internet circuits.


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The Union Updated May 7, 2013 09:34PM Published May 7, 2013 09:34PM Copyright 2013 The Union. All rights reserved. This material may not be published, broadcast, rewritten or redistributed.