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Contributor: How Telemedicine Augments the Resources of the Indian Health Service to Reach New Patients, Improve Outcomes


Telemedicine may be the future of health care for American Indians and Alaskan Natives who live in tribal communities and remote areas.

The Indian Health Service (IHS) cares for more than 2.2 million American Indians and Alaskan Natives across the country’s numerous tribal reservations, which are often located in very rural and isolated areas.

While the IHS does its very best to provide comprehensive and high-quality care to tribal communities, the government agency faces the same problems as many other health care providers serving remote regions: long distances, scarce resources, and limited staff make it difficult to connect patients with the right care at the right time.

These systemic challenges are amplified when it comes to complex emergency care, detailed specialty care, and behavioral health services.

Emergency departments in these rural areas are typically small and can only provide basic lifesaving care—and the nearest facility might be hours away for some patients. Meanwhile, an ongoing shortage of clinical and mental health providers means that specialists are few and far between.

Unfortunately, this combination of factors leaves many American Indian/Alaska Native communities without the ability to access care in a timely, convenient, and affordable manner. As a result, when patients do present to their providers, their diseases are often much more advanced and require significantly more high-level resources.

For the past 5 years, IHS has been working to change this troubling trend by leveraging telemedicine to enhance the exceptional work of IHS providers. Virtual care has made it faster and easier for American Indians and Alaskan Natives in the Great Plains region to access and benefit from high-quality health care—particularly in emergency situations.

Expanding Access to Critical Resources in Emergencies

Emergency care clinicians in rural areas have to be prepared for anything, from common injuries to rare illnesses. But with few resources on site and the nearest high-level trauma facilities often hours away, IHS emergency departments benefit from having a helping hand.

That’s where telemedicine comes into play. Just by pushing a button on the wall, on-site providers can bring in a virtual team of board-certified emergency physicians and critical care nurses for assistance with uncommon or complex procedures. The virtual team can observe the room via 2-way video to offer advice and give direction, where needed.

Mental health services in the emergency department can be provided using telemedicine in a similar manner. For example, psychiatrists can remotely assess people in crisis and make recommendations about medications or recommend a higher level of care, if necessary, so that each individual receives the most appropriate course of treatment.

Supporting On-site Clinicians With Experts in Their Field

Specialty services are also scarce across the Great Plains, despite the fact that many American Indian populations are more prone to certain issues, including autoimmune and endocrinology diseases, as well as dermatologic conditions such as scarring acne.

With telemedicine, clinic staff can connect with qualified specialists to provide consults. Carts equipped with video cameras and smart exam tools allow specialists to see and hear everything they need to make an accurate diagnosis from hundreds of miles away.

Telemedicine also helps to open conversations about mental and behavioral health concerns. Through home visits or clinic-based interactions, patients can receive assistance for depression, anxiety, substance abuse, attention deficit disorder, and other conditions.

Counseling from social workers is also available to address the social determinants of health and help communities overcome socioeconomic challenges.

Creating an Expectation of Reliable, Accessible Care for Patients and Providers

Telemedicine is truly transformational for remote tribal populations, as well as for the providers working so diligently to provide optimal care to their patients. Leveraging technology to expand the capacity of IHS facilities and extend the skills of on-site providers is crucial for overcoming provider shortages and preventing burnout in a high-stress environment.

By integrating behavioral health care and social work with emergency and specialty care, we can help IHS providers get ahead of the mental and physical health conditions that can disrupt communities, better preserving cherished traditions and building a more robust infrastructure for the future.

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