Dr. Juan Manuel Romero, a cardiologist at a hospital in Ciudad Obregon in Sonora, Mexico, engages in a pre-op consultation with Alma Guadalupe Xoletxilva and her doctor, Edgar Cuevas, who are 400 miles away in La Paz, Baja California. Besides enabling doctors who are geographically separated to hear and see each other while consulting, patient information such as charts and scans can be shared in seconds. (Intel Free Press used by Creative Commons 2.0)
A lot of facets of everyday life were disrupted during the COVID pandemic. However, one of the things that seemed to work and may be here to stay is telehealth. And Congressman Matt Rosendale, R-Montana, has introduced legislation that makes telehealth visits for behavioral health and counseling a permanent part of Medicare.
Telehealth, especially for mental health, seems like a natural fit for Montanans, many of whom live in places with a limited number of mental health services or have to drive hours to get to an appointment. Also, access to mental health professionals is one of the key issues when discussing the state’s higher suicide rate.
Telehealth visits of any kind were not very prevalent in Montana and elsewhere before the COVID pandemic. But lawmakers and health professionals rapidly made “Zoom” and other video conferencing services a key part of taking care of people during quarantines, lockdowns, social distancing and the pandemic. A spokesman for Rosendale said this takes the temporary rules instituted by Medicare during COVID and would make them permanent.
The bill, House Resolution 4012, has been assigned to two committees, the Energy Committee and Ways and Means.
“This is a huge, huge issue,” said Rosendale spokesman Harry Fones. “We saw telehealth used with great success during the pandemic. We’ve proven it works.”
Dr. Sarah Baxter, a licensed clinical psychologist in Hamilton, said this measure is supported by the Montana Psychological Association and she’s seen telehealth work in her practice.
“In a state like Montana, it’s a great option,” she said.
Sometimes, patients have several hours to drive just to make it to an appointment. Often, the commute takes longer than the session.
Other places are also learning how to support telehealth. For example, Baxter said that retail locations like Wal-Mart have set up telehealth conference rooms in their stores for veterans to use when they may not have access to the technology or privacy. In that way, the infrastructure to support more and better telehealth is growing.
“It’s opened a lot of people’s eyes to the possibilities,” she said.
She said it’s not ideal for every situation – for example, veterans or elderly patients who struggle to hear or may be unfamiliar with technology, or a child with attention-deficit disorder.
“But everyone has gotten better at running things like Zoom,” she said. “And missed appointments become an issue at times like in February. Sometimes, the weather is not manageable.”
She said one other issue that was made clear during the pandemic was the need for better broadband across Montana. If providers and patients use more video conferencing, that puts more demand on internet providers.
Rich Rasmussen, chief executive officer of the Montana Hospitals Association said that Rosendale’s proposal is a good start, but he should also include Medicaid, which would help many of the people most affected by the pandemic.
Fones said that much of Congress’ attention is going to infrastructure, but this is a straightforward issue that is common sense. For example, not only does the bill help cut down on the number of missed appointments, but it saves money for commuting, which may burden those on Medicare.
“I can’t imagine a bill like this would do anything other than help,” Baxter said.
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