BAMBERG — As the nation battles the coronavirus, the need for telehealth becomes more apparent.
In South Carolina, Palmetto Care Connections, a non-profit telehealth network, has been promoting telehealth to rural and underserved areas for more than a decade. Since 2010, PCC has helped rural health care providers implement telehealth solutions to see and treat patients virtually.
“We focus on three areas of work – telehealth programs, broadband and technology for rural health care providers throughout the state,” PCC Chief Executive Officer Kathy Schwarting said. PCC leads the South Carolina Health Care Broadband Consortium, filing for federal subsidies that result in up to 65% savings on broadband, internet costs and equipment for rural providers.
“In 2019, PCC ﬁled for $5,392,741 in broadband savings for S.C. health care providers, through the Health Care Connect Fund,” Schwarting said.
One of the health care providers that PCC has assisted is Bamberg Family Practice, a rural health clinic owned by Danette McAlhaney, MD. McAlhaney was one of the first private practitioners to adopt telehealth in rural S.C.
McAlhaney provides telehealth services to schools in her community, and she uses telehealth to connect patients in her office to specialists. In March, PCC helped McAlhaney implement a telehealth platform so she can provide care from her office to patients in their homes.
“Telehealth has so many possibilities,” McAlhaney said. “Especially in our current COVID-19 environment, telehealth is helping us keep patients safe. It allows us to diagnose and treat many illnesses and ailments while the patient is still at home, so they don’t have to come to our office waiting room and be exposed to other sick people.
“When our patients call for an office appointment, our staff determines whether a telehealth visit would be appropriate. We completed 88 telehealth visits in the first two weeks of implementing the telehealth platform and that number is increasing,” McAlhaney said.
Forty-year-old X-ray technician Rebecca Hutto of Bamberg used telehealth for a follow-up visit to prescribe medications.
“The telehealth application was quick and easy to set up on my computer. I liked that I didn’t have to go to the office, and I didn’t have to get dressed,” Hutto said. “In my job as an X-ray tech, I am potentially exposed to the coronavirus constantly, and even though I don’t have any symptoms, I didn’t want to put anyone at Bamberg Family Practice in jeopardy. I loved the telehealth visit and I hope they will continue after this crisis is over.”
CareSouth Carolina, a system of community health centers in the Pee Dee area, has also been using a telehealth platform that PCC helped implement.
“We have had patients who have COVID-19 symptoms and do not want to come into one of our offices. They call for a telehealth appointment, are screened, assessed and we determine whether they needed to be tested for COVID-19,” said Jeri Andrews, CareSouth Carolina mobile health and office site services program director. “If the patient needs to be tested, we make an appointment at the closest office to the patient. We have a front-door screener, and staff are prepared with the appropriate PPE to conduct the test. The test results are back within three days.
"If the patient does not require hospitalization, we do follow up telehealth visits to treat the patient at home, including behavioral health visits for depression or anxiety for those who are quarantined. One patient actually tested positive for COVID-19 after going through this process and is currently being treated at home,” Andrews said.
While telehealth’s attributes are numerous, there remain challenges with access to broadband and internet connection, particularly in S.C.’s rural areas.
“We are having firsthand experiences as we provide services via telehealth and telecommunication to our patients in this COVID-19 crisis,” CareSouth Chief Executive Officer Ann Lewis said. “We have run into significant problems with lack of internet access. It only takes a glance at our service area counties, Chesterfield, Marlboro, Dillon, Darlington and Lee, to see that we are facing serious problems with broadband availability and internet connection.”
In 2019, Palmetto Care Connections, South Carolina Office of Rural Health and the South Carolina Hospital Association partnered to commission a comprehensive evaluation of residential broadband capabilities throughout the state. The goal was to determine the gaps in internet access as a first step to making improvements that could impact health care, especially telehealth. As a result, detailed maps were produced depicting the availability and speed of broadband access in each county.
“Using Geographic Information System mapping and overlaying FCC Form 477 data, Speedtest Intelligence data and U.S. Census data, two maps were produced for each of our 46 counties,” Schwarting said. “One map shows the areas of need by indicating the download and upload speeds as well as the density of unserved households per square mile. The second map shows the type and speed of the best technology available in each area.”
The maps are posted on the Palmetto Care Connections website, palmettocareconnections.org, and are available to the public.
“PCC recently shared the maps with S.C. legislators to draw attention to the necessity for improved broadband,” Schwarting said. “In the midst of the COVID-19 pandemic, broadband and high-speed internet access are critical to the lives of all South Carolinians – impacting not only health care, but education, public safety, government operations, agriculture, the economy and more. It is our hope that the maps will help lawmakers, internet service providers and others prioritize the broadband needs of our state to help the most citizens, particularly in the rural areas.