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Clinicians: Tele-health is here to stay

Hospital hopes more people will use the service for routine visits, highlighting yet another example of the need for broadband

BRATTLEBORO — The COVID-19 pandemic forced Brattleboro Memorial Hospital, and other health care providers in Vermont, to come up with a new way of delivering health care.

BMH had been dabbling with tele-health - doing online health screenings and consultations - before the pandemic hit. With the hospital and its associated primary care practices all but shut down to incoming patients during the early months of the pandemic, the learning curve was steep and fast.

According to the hospital's data, BMH went from a handful of tele-health visits in January 2020 to 70 percent of primary care visits handled via tele-health by April 2020.

John Todd, a nurse practitioner from Putney Family Healthcare, and Dr. Tony Blofson, a family practice physician at Maplewood Family Practice, gave U.S. Rep. Peter Welch. D-Vt., a quick demonstration of how BMH's tele-health platform works. Both offices are departments of the hospital.

Todd explained that the hospital used software from New York–based Bluestream Health, having evaluated it as the simplest and easiest to use for both patients and clinicians. It allows for three-way conversations, for the easy addition of interpreters, family members, or specialists on a call, as well as screen sharing.

The software is open and networked and can be used on a variety of devices, so users don't have to download special applications or browser plug-ins.

“It is a widely used system,” Todd said, adding that other vendors offered BMH an opportunity to be beta testers for their software, but “we wanted something tried and true.”

To help Todd and Blofson demonstrate the software, Maeve Shaughnessy, the hospital's communications and marketing manager, became the patient.

They quickly determined that a rash on her arm was not caused by a tick bite and assured Shaughnessy that there was nothing to worry about.

“This little moment saved us a whole trip to the office,” said Todd.

It also saved the providers time, said Todd, noting bad-weather days during the winter when he couldn't get into the office and did tele-health consultations from his home.

Now, Todd said, the rate of use for tele-health is down to 19 percent, but the hospital hopes more people will see the convenience of using it for routine visits.

“It's helpful,” said Blofson, “One, it's convenient, and two, as millennials move into medicine, they are much more interested in quick and convenient. It doesn't replace the face-to-face visit, but it's useful for some things.”

That, he said, is a big reason why expanded and improved broadband and cellular phone service is a necessity for Vermont.

“If you want to try this out in Halifax with your iPhone, good luck,” Blofson said.

Welch, who is the head of the House Broadband Caucus, said getting better internet to rural areas has become a priority, even with his Republican colleagues in the House, after the pandemic forced everything from schooling to health care to office work to shift online.

“The case has been made,” he said. “Now we're moving into the execution phase.”

With funding coming to Vermont through the American Rescue Plan Act (ARPA) and more funding possible from President Biden's proposed infrastructure spending plan, Welch said the federal government is ready to provide the needed resources.

“Now, we're at the 'grinding it out' stage of getting the fiber line out to that distant dirt road in Halifax,” he said. “I think - really think - we're going to get there.”

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