2015 Articles
By Reza Ghadimi
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12-31-2015
As we say goodbye to 2015, we look forward to a new year full of promises for telehealth. But we must find needy areas and guide our resources toward them.
One bit of news that got lost in all the others, was the recent legislative action that renewed funding for the government agencies. Hidden in the volumes of bureaucratic jargon was a renewal budget for the Peace Corps – a mere $380 M. Peace Corps is perhaps one of the best ways to expose our citizens to the plight of others around the world, while bringing them help and educating them of our philosophy and way of life. Although the program is open to all, it is mostly young, ideological, and adventurous people who volunteer for it. I have worked with many of these volunteers and have been most impressed with their zeal, energetic and passionate outlook toward their work. On their return home, they are some of the best people anyone can employ.
One area of concern that has been overlooked is the healthcare of these volunteers, themselves. Although Peace Corps employs nurses and physicians to care for them, often they have to be removed from their environment and location to receive the medical care they need. For this reason, many do not report or seek help in a timely fashion, as they do not wish to leave their assigned location. However most of their maladies can be controlled and prevented if they had access to medical advise early enough. For example, if these folks could contact their own providers back home, who know them and their medical history, they could receive the help they need. This could be done through telehealth.
In finding and solving these types of needs, telehealth could be the true life saver it needs to be. Lets hope for clarity and perspicuity of our mission in the coming year. Our troubled world could surely use it.
-------------------------------------------
12-24-2015
As we find ourselves immersed in the holiday season, this is a time to reflect upon our blessings, challenges, and opportunities for the future. Your involvement and passion for telehealth being used to improve the healthcare and quality of life for people around the world is, indeed, a blessing.
Being able to effectively use telehealth is also, in deed, a challenge but worthy of our efforts and persistence as we look to see telehealth become part of our transforming healthcare systems, tools that can increase patient centered access to care, improve health outcomes, and decrease costs without sacrificing quality of care (the corner stones of the "Triple Aim").
Together, we have an incredible opportunity to use telehealth to improve health around the world using these evolving information and communication technologies; thinking globally but acting locally. Here's to an amazing new year for telehealth and your opportunity to truly make a difference!
With kind regards, Dale Alverson, MD, Chairman of the New Mexico Telehealth Alliance.
Merry Christmas to all
-------------------------------------------
12-17-2015
Something extraordinary is happening in the world!
In watching the news of all that is happening around us, we may feel that the entire universe is against us. Perhaps the chaos of change is waiting for proper direction. An article by Gustavo Tanaka of Brazil reveals; "Something Extraordinary Is Happening in the World, And Most People Haven't Noticed"
Mr. Tanaka's observation is not unique. Many see opportunities to be seized . We are at a great crossroad in history. But the new road ahead of us has not yet been made or even mapped out. How we plan it, map it, build it, and use it will determine the outcome of our future in everything, healthcare included. So as we take time off to celebrate the wonderful traditions of this time of the year, lets take a quiet few moments to reflect on what is ahead, how to plan for it and how to built it so that it will serve us and humanity positively, productively and effectively.
From all of us at NM Telehealth Alliance
Have a Merry Christmas and Happy Holidays!
-------------------------------------------
12-10-2015
Calvin Coolidge gave the first presidential address that was broadcast on the radio on December 6th, 1923. In less than a hundred years, we have moved from a simple radio broadcast to the astounding technology of communication that exists today. It was President Coolidge that helped create the Federal Radio Commission, which has now evolved to become the Federal Communications Commission (FCC). While President Coolidge gave the first presidential address that was broadcast on radio, President Obama became the first president to hold virtual gatherings and town halls using Twitter, Facebook, LinkedIn, etc.
In some ways our (my) generation has witnessed unprecedented history in the making. Many of us grew up studying by candle-light and kerosene lamps. My olfactory senses still recall the odor of kerosene, as I was in charge of purchasing it daily for our household. Electricity, radio, and even telephone was alien to many during our childhood. In one lifetime, we developed the technology that sent us to the moon and back, put a rover on Mars and had the Voyager space craft carry man's message beyond our solar system. Just recently, I was amused by a question from a young family member; "Uncle Reza, what is a phone booth?"
All the technology however has not made us wiser. It seems that the most advances are made in warfare and conflict creation. What a wonderful world would it be, if the "Military Industrial Complex" was changed into a "Health and Peace Development Complex." Today in healthcare as well as politics we have so much ideology, dogma, and subjectivism, yet little objectivity, logic, and sensibility.
Coolidge was "distinguished for character more than for heroic achievement," wrote a Democratic admirer, Alfred E. Smith. "His great task was to restore the dignity and prestige of the Presidency when it had reached the lowest ebb in our history ... in a time of extravagance and waste...."
Sounds familiar?
Before his death in January 1933, Coolidge confided to an old friend, ". . . I feel I no longer fit in with these times." This too is something many of us can relate to! Still it is us who remember kerosene lamps and phone booths that must educate the younger generation of the rapid changes that our world is witnessing and try to maintain the dignity and the humanity of mankind. And there is no better way to achieve this but through the technology of tele-education and telehealth.
-------------------------------------------
12-3-2015
The rural communities of our country need our help and attention. According to the National Organization of State Offices of Rural Health;
"Rural communities are wonderful places to live and work, which is why nearly 62 million people – nearly one in five Americans – call them home. These small towns, farming communities and frontier areas are places where neighbors know each other, listen to each other, respect each other and work together to benefit the greater good. They are also some of the best places to start a business and test your “entrepreneurial spirit.” These communities provide the rest of the country with a wealth of services and commodities, and they are the economic engine that has helped the United State become the world economic power it is today.
These rural communities also have unique healthcare needs. Today more than ever, rural communities must address accessibility issues, a lack of healthcare providers, the needs of an aging population suffering from a greater number of chronic conditions, and larger percentages of un- and underinsured citizens. And rural hospitals – which are often the economic foundation of their communities in addition to being the primary providers of care – struggle daily as declining reimbursement rates and disproportionate funding levels make it challenging to serve their residents."
Telehealth is the way to bring healthcare and education to these communities, cost effectively, timely and safely.
-------------------------------------------
11-19-2015
This is World Antibiotic Awareness week. It is amazing that antibiotics are not even a hundred years old and yet we have developed, expanded and used them to such levels that many diseases are now resistant to them. Is this due to our lack of full knowledge of them, over availability, or the financial gain of the manufacturers of these products? Many reports seem to indicate that places with less access to these drugs harbor healthier populations. In our overactive and rushed societies, we are often forced to act against our better judgment. Like most providers, I too had my share of anxious mothers who demanded a coarse of antibiotics for their sick child, not because the child needed it but because the mother desperately stated that "she couldn't afford to miss work." For many years though, people did just fine without these wonder drugs. Even today many do without them;
I was working on a small island in the Caribbean many years ago. When I first got to the island, a child of 11 years of age was referred to me who had suffered a fall resulting in a compound (open) fracture of his elbow. The wound was a week old and infected. I admitted him and ordered IV antibiotics. Next morning, while making my rounds, I saw no notes regarding the ordered meds. The respond to my inquiry was; "OK".
"What do you mean OK?", I asked the nurse. "Has this child had his meds or not?"
"NO!" was the answer. "And why not", I asked somewhat irate.
"We don't have any antibiotics." was the answer. The end result was that no antibiotics of any kind existed on the island. "When the ship come," I was told, "maybe he will bring medicine." There was no telling when the ship would come.
I remember, my Grandmother would allow flies to lay their eggs in such wounds and the resulting larva would eat the infection. The child's mother told me that the local medicine man had made the same kind of a suggestion but she had brought him to us to receive modern care. Of course I, being the representative of the American medical establishment couldn't suggest maggots. In the end an Indian physician working on the island came to my rescue. He applied Plaster of Paris bandages to the elbow without any padding. The cast not only immobilized the elbow, the plaster acted as a wick and sucked all the puss out, healing the wound. When I left the island several months later. The child's elbow had healed and he had fairly good range of motion. It then behooves us to keep the old practices alive. More and more, it is being discovered that there still is a viable integrity to their use. Including the use of maggots and leeches. Before the discover of antibiotics, they worked for thousands of years.
So it is not surprising that the UN's WHO is making a special effort to improve awareness of the overuse of antibiotics. One of the key objectives of the plan is to improve understanding of antimicrobial resistance through effective communication, education and training. Tele-communication, Telehealth and Tele-education can play a commanding role here, reaching millions around the world effectively, safely and timely.
-------------------------------------------
10-22-2015
Yesterday in 1879, was the day when Thomas Edison figured out a workable electric light bulb. It is amazing that the discovery of, and invention of usable electricity is just a little over a hundred years old. Yet since it's invention, we have moved light years ahead in every aspect of our lives. From transportation to communication, in science and technology, agriculture and medicine, so on and so on. It has irreversibly and irrevocably changed man's destiny in the cosmos. We have moved so fast and so far that much of it seems a blur.
I grew up without electricity. Electricity first came to our town when I was fourteen years old. I clearly remember that day, and I remember my grandmother's reaction to it. When I turned the switch on in our house for the first time, she shivered and said "that is the work of the devil". She was not the only person who told me that. When I was working on the island of Dominica in the Caribbean - after Hurricane David demolished the place, I met an old Carib Indian man who refused to have electricity in his house, claiming it was evil and would drain his soul. A similar concern, I heard from an elderly Navajo woman once. Of course such superstitions maybe unfounded and baseless, but can we ignore the fact that electricity has propelled us so far past our traditions, beliefs, and even faith that we look at the world around us with such vision and mind that could make us forget our roots.
our present vision of the world is so far removed from that of our predecessors
In our zeal to move faster and faster into the future, we must keep in mind that unless humanity moves forward together, those in the front may become so separated from the others that we may completely lose sight of each other. That would be a calamity neither group can afford. Fortunately the tools are here for us all to advance together. We just need to use them. My entire life as an adult has been spent in healthcare, so I can only speak of this arena. Here I see technology such as "telehealth and telemedicine" provide us with opportunities and solutions to keep us all healthy as we move forward. Let us use this gift against illness, disease, poverty and illiteracy. If we keep our people - all people - educated, healthy and well cared for, moving forward for the entire humanity would be a good possibility. I think that would please Thomas Edison very much.
-------------------------------------------
10-15-2015
Two days ago, we held the first Interstate Telehealth Discussion Group. Reception was very good and I feel that this area of telehealth will grow rapidly. Absent however, were young providers and telehealth users. I am consistently surprised to see how little attention is given to this new technology by the newer generation. Perhaps they feel that since they are the ones who actually developed the system and have implemented it, there is no reason for them to participate in the organizational aspect of a system that is still mostly ruled and run by older folks. Maybe they are right.
When I first entered the world of medicine in the ripe age of fourteen in the middle of last century, we didn't even have anything that could be called technological to today's standard. We had reusable needles and glass syringes, plaster of Paris came in powder form in a bucket, and x-ray machines stood in the corner of a room. We carried an alcohol lamp and sterilized the needle and syringes by boiling them in water before each use. When a patient was being x-rayed, usually his or her family were in the room with them, including their children. Antibiotics were new and still looked at with skepticism. We have come a long way in the past half a century. Today we consider all of the above archaic, old and even barbaric. Yet in their own time, they were state of the art medicine.
Much of what we use today was considered science fiction at the turn of the last century. The rate at which our world is progressing, will put us decades ahead in the next generation. By involving themselves, our young practitioners could benefit immensely in understanding, forecasting and developing the next generation of medical devices, medications and technologies. I - for one - would love to see younger people at our meetings, conferences and organizations - government and private. The future belongs to them and the better they understand the present, the better they could form what is coming their way.
What would they say of today, sixty years from now, I wonder.
-------------------------------------------
10-8-2015
In 1977, I attended the 5th annual Balloon Fiesta in Albuquerque. A good friend of mine; Jeff Dodd is a balloonist and had his balloon in the event. He asked me to join him that day. We soared into the skies over the city and the winds blew us over the Sunport. FAA closed the airport and we finished by landing in Kirtland Air Force Base. We were laughing and joking about it all, but found that the joke was on us as our ground crew could not get on the base to pick us up. We sat for several hours waiting and drinking the champagne Jeff had brought with him till we were finally picked up. Later we drove down Central Avenue in a parade, throwing candy to children and exchanging phone numbers with pretty girls.
The fiesta has come a long way since then. In the early 1990s when the event was first moved to the present location, I was working at Lovelace and we had a medical booth at the Fiesta - still there. I was one of the first volunteers to man the booth. Communication was via walkie-talkie and delayed. Whether we were piloting balloons and talking to our ground crew or receiving calls at the medical booth to alert us of injuries coming our way, connections were slow and often poor. Today, GPS, Internet, Cell Phones and the like make navigation, communication and information available instantly. Much has changed in the world of medicine as well as ballooning in the last forty years. Today, telehealth makes it possible to reach people in need at far corners of the world. We can teach, educate, attend, examine, diagnose and treat in all kinds of situations. Experts can share their knowledge with colleagues far away. But accepting this new way of life is difficult for many of our people. Still change is here and technology is moving medicine - like aviation - forward. It behooves us to take charge of our destiny, otherwise others will do it for us at an unfavorable cost to us. It is better for medical professionals to control the advance of healthcare through technology, rather than technology adopt medicine to it's needs.
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10-1-2015
The United Nations General Assembly is meeting in New York this week. It is disappointing however, to see how little coverage our media is giving to this important event. Fortunately through the power of internet we can - and should - watch and listen to everyone of these leaders' address to the UN General Assembly. The UN broadcasts the entire meeting live everyday. Listen to this live broadcast here: UN General Assembly
In listening to all the leaders of the world, one thing that routinely and regularly is addressed as a major problem and a critical threat to humanity is the state of healthcare in the world. Nations; rich and poor, strong and weak, populated or not have the same universal concerns and complaints. In an era, when the world of technology and medicine has made great advances, it is disappointing that one of the number one concerns in the world is it's healthcare status. Yet this need not be.
Today's global connections could eliminate much of the disparity. Telehealth can bring relief to every part of the world through our modern satellite communication. Universities, major medical centers, and research institutions can all be connected to the most remote parts of the world and share their knowledge. Let us use this opportunity to reach all leaders and educate them on the use of this technology.
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9-24-2015
Monday, September 21st was The International Day of Peace. Established in 1981 by the United Nations General Assembly; the International Day of Peace is observed around the world. The General Assembly has declared this as a day devoted to strengthening the ideals of peace, both within and among all nations and peoples. To commemorate the Day through education and public awareness on issues related to peace.
Nothing in the world could be more peaceful than a healthy community, and nothing could show more peaceful intentions than caring for your foe's mental and physical well-being. Telehealth makes it possible to care for your friends and foes by providing them the necessary means and advise without endangering any of your own people. Sharing medical knowledge to improve your enemy's health is a gift that cannot be ignored or underestimated. Such acts of kindness and good intentions surely reveal benevolence and truly work toward peace.
O ye people, be ye healed.
Life anew I bring unto ye.
O ye people, be ye healed.
Life anew I bring unto ye.
Through the Father over all
Do I thus.
Life anew I bring unto ye.
Good Eagle (Wanbli-Waste) - 19th century Dakota Sioux holy man
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9-17-2015
Today is Citizenship day. With the movement of all the migrants, refugees, and seekers of a better life, the world is being literarily remade and the ramification of all the changes are profound and will be long lasting. Politics aside, we all have to appreciate the fact that seeking a better life is a fundamental and natural desire that all creatures of God have and strive for. Although our birthplace may determine our race and certain minor anatomical differences, it should not bind us to a permanent geographical region. After all, if not for man's desire to migrate in search of betterment, we all would still be living in Africa.
There is an old saying that; "Every man is born twice. First to the parents and family that bore him and second to the people and society he/she chooses to live with." We the people of this planet must share it's resources equally and evenly. Only then; man's true potential for advancement and achievement will propel him forward to new accomplishments.
In the meantime we have the technological means to share our knowledge and our abilities with one another. Tele-education and telehealth are two areas where we can profoundly help each other's achievements. Let us share this passion of being human with all mankind and truly move ourselves into the Twenty First Century and beyond. Let us use our technology to the betterment of all people, for after all we are all citizens of this small planet.
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9-10-2015
September 6-12 is National Suicide Prevention Week.
According to the NM Department of Health, the number of suicides for teens in the United States in 2013 was around 4600 – that’s an average of 12 per day. [Read the full report here]
The Department of Health recently completed a report examining teen suicide trends over ten years in our state and found suicide attempts declining by 35 percent over the decade.
The report, entitled YRRS Report 2013: Statewide High School Mental Health was released recently in conjunction with September’s National Suicide Prevention Month and National Suicide Prevention Week. The research is clear: increasing access to behavioral health care can help prevent suicide attempts among youth.Obviously mental health and behavioral health crisis are a major concern in our country and state. Telehealth is one way many of the behavioral health concerns can be handled. Yet there is still major obstacles in implementing this useful tools. Our legislators, both at national and state levels need to be made aware and educated on the benefits and usefulness of this great asset. This is National Suicide Prevention Month and National Suicide Prevention Week, September 6-12. Please call your state and national representatives and senators and make them aware of the use of telehealth in dealing with this crisis.
As we say goodbye to 2015, we look forward to a new year full of promises for telehealth. But we must find needy areas and guide our resources toward them.
One bit of news that got lost in all the others, was the recent legislative action that renewed funding for the government agencies. Hidden in the volumes of bureaucratic jargon was a renewal budget for the Peace Corps – a mere $380 M. Peace Corps is perhaps one of the best ways to expose our citizens to the plight of others around the world, while bringing them help and educating them of our philosophy and way of life. Although the program is open to all, it is mostly young, ideological, and adventurous people who volunteer for it. I have worked with many of these volunteers and have been most impressed with their zeal, energetic and passionate outlook toward their work. On their return home, they are some of the best people anyone can employ.
One area of concern that has been overlooked is the healthcare of these volunteers, themselves. Although Peace Corps employs nurses and physicians to care for them, often they have to be removed from their environment and location to receive the medical care they need. For this reason, many do not report or seek help in a timely fashion, as they do not wish to leave their assigned location. However most of their maladies can be controlled and prevented if they had access to medical advise early enough. For example, if these folks could contact their own providers back home, who know them and their medical history, they could receive the help they need. This could be done through telehealth.
In finding and solving these types of needs, telehealth could be the true life saver it needs to be. Lets hope for clarity and perspicuity of our mission in the coming year. Our troubled world could surely use it.
-------------------------------------------
12-24-2015
As we find ourselves immersed in the holiday season, this is a time to reflect upon our blessings, challenges, and opportunities for the future. Your involvement and passion for telehealth being used to improve the healthcare and quality of life for people around the world is, indeed, a blessing.
Being able to effectively use telehealth is also, in deed, a challenge but worthy of our efforts and persistence as we look to see telehealth become part of our transforming healthcare systems, tools that can increase patient centered access to care, improve health outcomes, and decrease costs without sacrificing quality of care (the corner stones of the "Triple Aim").
Together, we have an incredible opportunity to use telehealth to improve health around the world using these evolving information and communication technologies; thinking globally but acting locally. Here's to an amazing new year for telehealth and your opportunity to truly make a difference!
With kind regards, Dale Alverson, MD, Chairman of the New Mexico Telehealth Alliance.
Merry Christmas to all
-------------------------------------------
12-17-2015
Something extraordinary is happening in the world!
In watching the news of all that is happening around us, we may feel that the entire universe is against us. Perhaps the chaos of change is waiting for proper direction. An article by Gustavo Tanaka of Brazil reveals; "Something Extraordinary Is Happening in the World, And Most People Haven't Noticed"
Mr. Tanaka's observation is not unique. Many see opportunities to be seized . We are at a great crossroad in history. But the new road ahead of us has not yet been made or even mapped out. How we plan it, map it, build it, and use it will determine the outcome of our future in everything, healthcare included. So as we take time off to celebrate the wonderful traditions of this time of the year, lets take a quiet few moments to reflect on what is ahead, how to plan for it and how to built it so that it will serve us and humanity positively, productively and effectively.
From all of us at NM Telehealth Alliance
Have a Merry Christmas and Happy Holidays!
-------------------------------------------
12-10-2015
Calvin Coolidge gave the first presidential address that was broadcast on the radio on December 6th, 1923. In less than a hundred years, we have moved from a simple radio broadcast to the astounding technology of communication that exists today. It was President Coolidge that helped create the Federal Radio Commission, which has now evolved to become the Federal Communications Commission (FCC). While President Coolidge gave the first presidential address that was broadcast on radio, President Obama became the first president to hold virtual gatherings and town halls using Twitter, Facebook, LinkedIn, etc.
In some ways our (my) generation has witnessed unprecedented history in the making. Many of us grew up studying by candle-light and kerosene lamps. My olfactory senses still recall the odor of kerosene, as I was in charge of purchasing it daily for our household. Electricity, radio, and even telephone was alien to many during our childhood. In one lifetime, we developed the technology that sent us to the moon and back, put a rover on Mars and had the Voyager space craft carry man's message beyond our solar system. Just recently, I was amused by a question from a young family member; "Uncle Reza, what is a phone booth?"
All the technology however has not made us wiser. It seems that the most advances are made in warfare and conflict creation. What a wonderful world would it be, if the "Military Industrial Complex" was changed into a "Health and Peace Development Complex." Today in healthcare as well as politics we have so much ideology, dogma, and subjectivism, yet little objectivity, logic, and sensibility.
Coolidge was "distinguished for character more than for heroic achievement," wrote a Democratic admirer, Alfred E. Smith. "His great task was to restore the dignity and prestige of the Presidency when it had reached the lowest ebb in our history ... in a time of extravagance and waste...."
Sounds familiar?
Before his death in January 1933, Coolidge confided to an old friend, ". . . I feel I no longer fit in with these times." This too is something many of us can relate to! Still it is us who remember kerosene lamps and phone booths that must educate the younger generation of the rapid changes that our world is witnessing and try to maintain the dignity and the humanity of mankind. And there is no better way to achieve this but through the technology of tele-education and telehealth.
-------------------------------------------
12-3-2015
The rural communities of our country need our help and attention. According to the National Organization of State Offices of Rural Health;
"Rural communities are wonderful places to live and work, which is why nearly 62 million people – nearly one in five Americans – call them home. These small towns, farming communities and frontier areas are places where neighbors know each other, listen to each other, respect each other and work together to benefit the greater good. They are also some of the best places to start a business and test your “entrepreneurial spirit.” These communities provide the rest of the country with a wealth of services and commodities, and they are the economic engine that has helped the United State become the world economic power it is today.
These rural communities also have unique healthcare needs. Today more than ever, rural communities must address accessibility issues, a lack of healthcare providers, the needs of an aging population suffering from a greater number of chronic conditions, and larger percentages of un- and underinsured citizens. And rural hospitals – which are often the economic foundation of their communities in addition to being the primary providers of care – struggle daily as declining reimbursement rates and disproportionate funding levels make it challenging to serve their residents."
Telehealth is the way to bring healthcare and education to these communities, cost effectively, timely and safely.
-------------------------------------------
11-19-2015
This is World Antibiotic Awareness week. It is amazing that antibiotics are not even a hundred years old and yet we have developed, expanded and used them to such levels that many diseases are now resistant to them. Is this due to our lack of full knowledge of them, over availability, or the financial gain of the manufacturers of these products? Many reports seem to indicate that places with less access to these drugs harbor healthier populations. In our overactive and rushed societies, we are often forced to act against our better judgment. Like most providers, I too had my share of anxious mothers who demanded a coarse of antibiotics for their sick child, not because the child needed it but because the mother desperately stated that "she couldn't afford to miss work." For many years though, people did just fine without these wonder drugs. Even today many do without them;
I was working on a small island in the Caribbean many years ago. When I first got to the island, a child of 11 years of age was referred to me who had suffered a fall resulting in a compound (open) fracture of his elbow. The wound was a week old and infected. I admitted him and ordered IV antibiotics. Next morning, while making my rounds, I saw no notes regarding the ordered meds. The respond to my inquiry was; "OK".
"What do you mean OK?", I asked the nurse. "Has this child had his meds or not?"
"NO!" was the answer. "And why not", I asked somewhat irate.
"We don't have any antibiotics." was the answer. The end result was that no antibiotics of any kind existed on the island. "When the ship come," I was told, "maybe he will bring medicine." There was no telling when the ship would come.
I remember, my Grandmother would allow flies to lay their eggs in such wounds and the resulting larva would eat the infection. The child's mother told me that the local medicine man had made the same kind of a suggestion but she had brought him to us to receive modern care. Of course I, being the representative of the American medical establishment couldn't suggest maggots. In the end an Indian physician working on the island came to my rescue. He applied Plaster of Paris bandages to the elbow without any padding. The cast not only immobilized the elbow, the plaster acted as a wick and sucked all the puss out, healing the wound. When I left the island several months later. The child's elbow had healed and he had fairly good range of motion. It then behooves us to keep the old practices alive. More and more, it is being discovered that there still is a viable integrity to their use. Including the use of maggots and leeches. Before the discover of antibiotics, they worked for thousands of years.
So it is not surprising that the UN's WHO is making a special effort to improve awareness of the overuse of antibiotics. One of the key objectives of the plan is to improve understanding of antimicrobial resistance through effective communication, education and training. Tele-communication, Telehealth and Tele-education can play a commanding role here, reaching millions around the world effectively, safely and timely.
-------------------------------------------
10-22-2015
Yesterday in 1879, was the day when Thomas Edison figured out a workable electric light bulb. It is amazing that the discovery of, and invention of usable electricity is just a little over a hundred years old. Yet since it's invention, we have moved light years ahead in every aspect of our lives. From transportation to communication, in science and technology, agriculture and medicine, so on and so on. It has irreversibly and irrevocably changed man's destiny in the cosmos. We have moved so fast and so far that much of it seems a blur.
I grew up without electricity. Electricity first came to our town when I was fourteen years old. I clearly remember that day, and I remember my grandmother's reaction to it. When I turned the switch on in our house for the first time, she shivered and said "that is the work of the devil". She was not the only person who told me that. When I was working on the island of Dominica in the Caribbean - after Hurricane David demolished the place, I met an old Carib Indian man who refused to have electricity in his house, claiming it was evil and would drain his soul. A similar concern, I heard from an elderly Navajo woman once. Of course such superstitions maybe unfounded and baseless, but can we ignore the fact that electricity has propelled us so far past our traditions, beliefs, and even faith that we look at the world around us with such vision and mind that could make us forget our roots.
our present vision of the world is so far removed from that of our predecessors
In our zeal to move faster and faster into the future, we must keep in mind that unless humanity moves forward together, those in the front may become so separated from the others that we may completely lose sight of each other. That would be a calamity neither group can afford. Fortunately the tools are here for us all to advance together. We just need to use them. My entire life as an adult has been spent in healthcare, so I can only speak of this arena. Here I see technology such as "telehealth and telemedicine" provide us with opportunities and solutions to keep us all healthy as we move forward. Let us use this gift against illness, disease, poverty and illiteracy. If we keep our people - all people - educated, healthy and well cared for, moving forward for the entire humanity would be a good possibility. I think that would please Thomas Edison very much.
-------------------------------------------
10-15-2015
Two days ago, we held the first Interstate Telehealth Discussion Group. Reception was very good and I feel that this area of telehealth will grow rapidly. Absent however, were young providers and telehealth users. I am consistently surprised to see how little attention is given to this new technology by the newer generation. Perhaps they feel that since they are the ones who actually developed the system and have implemented it, there is no reason for them to participate in the organizational aspect of a system that is still mostly ruled and run by older folks. Maybe they are right.
When I first entered the world of medicine in the ripe age of fourteen in the middle of last century, we didn't even have anything that could be called technological to today's standard. We had reusable needles and glass syringes, plaster of Paris came in powder form in a bucket, and x-ray machines stood in the corner of a room. We carried an alcohol lamp and sterilized the needle and syringes by boiling them in water before each use. When a patient was being x-rayed, usually his or her family were in the room with them, including their children. Antibiotics were new and still looked at with skepticism. We have come a long way in the past half a century. Today we consider all of the above archaic, old and even barbaric. Yet in their own time, they were state of the art medicine.
Much of what we use today was considered science fiction at the turn of the last century. The rate at which our world is progressing, will put us decades ahead in the next generation. By involving themselves, our young practitioners could benefit immensely in understanding, forecasting and developing the next generation of medical devices, medications and technologies. I - for one - would love to see younger people at our meetings, conferences and organizations - government and private. The future belongs to them and the better they understand the present, the better they could form what is coming their way.
What would they say of today, sixty years from now, I wonder.
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10-8-2015
In 1977, I attended the 5th annual Balloon Fiesta in Albuquerque. A good friend of mine; Jeff Dodd is a balloonist and had his balloon in the event. He asked me to join him that day. We soared into the skies over the city and the winds blew us over the Sunport. FAA closed the airport and we finished by landing in Kirtland Air Force Base. We were laughing and joking about it all, but found that the joke was on us as our ground crew could not get on the base to pick us up. We sat for several hours waiting and drinking the champagne Jeff had brought with him till we were finally picked up. Later we drove down Central Avenue in a parade, throwing candy to children and exchanging phone numbers with pretty girls.
The fiesta has come a long way since then. In the early 1990s when the event was first moved to the present location, I was working at Lovelace and we had a medical booth at the Fiesta - still there. I was one of the first volunteers to man the booth. Communication was via walkie-talkie and delayed. Whether we were piloting balloons and talking to our ground crew or receiving calls at the medical booth to alert us of injuries coming our way, connections were slow and often poor. Today, GPS, Internet, Cell Phones and the like make navigation, communication and information available instantly. Much has changed in the world of medicine as well as ballooning in the last forty years. Today, telehealth makes it possible to reach people in need at far corners of the world. We can teach, educate, attend, examine, diagnose and treat in all kinds of situations. Experts can share their knowledge with colleagues far away. But accepting this new way of life is difficult for many of our people. Still change is here and technology is moving medicine - like aviation - forward. It behooves us to take charge of our destiny, otherwise others will do it for us at an unfavorable cost to us. It is better for medical professionals to control the advance of healthcare through technology, rather than technology adopt medicine to it's needs.
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10-1-2015
The United Nations General Assembly is meeting in New York this week. It is disappointing however, to see how little coverage our media is giving to this important event. Fortunately through the power of internet we can - and should - watch and listen to everyone of these leaders' address to the UN General Assembly. The UN broadcasts the entire meeting live everyday. Listen to this live broadcast here: UN General Assembly
In listening to all the leaders of the world, one thing that routinely and regularly is addressed as a major problem and a critical threat to humanity is the state of healthcare in the world. Nations; rich and poor, strong and weak, populated or not have the same universal concerns and complaints. In an era, when the world of technology and medicine has made great advances, it is disappointing that one of the number one concerns in the world is it's healthcare status. Yet this need not be.
Today's global connections could eliminate much of the disparity. Telehealth can bring relief to every part of the world through our modern satellite communication. Universities, major medical centers, and research institutions can all be connected to the most remote parts of the world and share their knowledge. Let us use this opportunity to reach all leaders and educate them on the use of this technology.
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9-24-2015
Monday, September 21st was The International Day of Peace. Established in 1981 by the United Nations General Assembly; the International Day of Peace is observed around the world. The General Assembly has declared this as a day devoted to strengthening the ideals of peace, both within and among all nations and peoples. To commemorate the Day through education and public awareness on issues related to peace.
Nothing in the world could be more peaceful than a healthy community, and nothing could show more peaceful intentions than caring for your foe's mental and physical well-being. Telehealth makes it possible to care for your friends and foes by providing them the necessary means and advise without endangering any of your own people. Sharing medical knowledge to improve your enemy's health is a gift that cannot be ignored or underestimated. Such acts of kindness and good intentions surely reveal benevolence and truly work toward peace.
O ye people, be ye healed.
Life anew I bring unto ye.
O ye people, be ye healed.
Life anew I bring unto ye.
Through the Father over all
Do I thus.
Life anew I bring unto ye.
Good Eagle (Wanbli-Waste) - 19th century Dakota Sioux holy man
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9-17-2015
Today is Citizenship day. With the movement of all the migrants, refugees, and seekers of a better life, the world is being literarily remade and the ramification of all the changes are profound and will be long lasting. Politics aside, we all have to appreciate the fact that seeking a better life is a fundamental and natural desire that all creatures of God have and strive for. Although our birthplace may determine our race and certain minor anatomical differences, it should not bind us to a permanent geographical region. After all, if not for man's desire to migrate in search of betterment, we all would still be living in Africa.
There is an old saying that; "Every man is born twice. First to the parents and family that bore him and second to the people and society he/she chooses to live with." We the people of this planet must share it's resources equally and evenly. Only then; man's true potential for advancement and achievement will propel him forward to new accomplishments.
In the meantime we have the technological means to share our knowledge and our abilities with one another. Tele-education and telehealth are two areas where we can profoundly help each other's achievements. Let us share this passion of being human with all mankind and truly move ourselves into the Twenty First Century and beyond. Let us use our technology to the betterment of all people, for after all we are all citizens of this small planet.
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9-10-2015
September 6-12 is National Suicide Prevention Week.
According to the NM Department of Health, the number of suicides for teens in the United States in 2013 was around 4600 – that’s an average of 12 per day. [Read the full report here]
The Department of Health recently completed a report examining teen suicide trends over ten years in our state and found suicide attempts declining by 35 percent over the decade.
The report, entitled YRRS Report 2013: Statewide High School Mental Health was released recently in conjunction with September’s National Suicide Prevention Month and National Suicide Prevention Week. The research is clear: increasing access to behavioral health care can help prevent suicide attempts among youth.Obviously mental health and behavioral health crisis are a major concern in our country and state. Telehealth is one way many of the behavioral health concerns can be handled. Yet there is still major obstacles in implementing this useful tools. Our legislators, both at national and state levels need to be made aware and educated on the benefits and usefulness of this great asset. This is National Suicide Prevention Month and National Suicide Prevention Week, September 6-12. Please call your state and national representatives and senators and make them aware of the use of telehealth in dealing with this crisis.
9-3-2015 - Visiting Friends
A while back, I was visiting a colleague who is a Native American on the Navajo reservation and she asked if I could go with her to see her aunt who had injured her leg. She lived about thirty miles deeper in the reservation. We drove her Land Cruiser off the pavement about 3 miles past her home and headed into the high country of the Navajo world on a dirt road. About twenty miles down that road, we turned off onto a primitive road and headed deeper into the hills. Finally we reached her aunt’s house at the end of what was now more like a trail than a road. Her aunt lived in a one room adobe dwelling with no electricity or running water.
Her leg was swollen and discolored but she was still walking on it with the help of a self-made cane. Even through the edema, I could feel the incongruity of the bone. "There is an obvious fracture here," I told my friend "I think we should take her back with us and get an x-ray of her leg." She smiled and told me that she will not come with us but still translated. To make the long story short, all our reasoning and rationalizing was for naught. She had a herd of sheep and goats to care for and would not leave them. Despite the fact that we promised to return her home the same day. I started to insist but my friend stopped me and said; "you are not listening to her, she won’t go!"
There were good pulses, sensory and motor functions were intact. So we applied the leg brace my friend had so thoughtfully brought with her and showed her how to apply it properly. She patiently listened and even practiced it a couple of times. Then carefully folded the brace and set it aside.
On the way back, my friend told me that her aunt had not been off the reservation for many years. "She lost her husband a while back and had been living by herself, isolated and happy. Local people and the Navajo Police check on her once in a while and bring her provisions in exchange for one of her sheep or goats. She does just fine without electricity and indoor plumbing. Computers, internet and even cell phones are completely alien to her." I smiled and we exchanged stories and wondered how this could be that people should live so isolated in this country of ours, but felt a gratitude that people like her keep traditions alive and are the foundation of our old cultures.
Today telehealth and telemedicine can help provide for our country-folk living in such isolation while preserving their culture and way of life. Understanding cultures and respecting their way of life allows us to be respected by them, thus developing a mutual appreciation which in turn will help in treating them. Technology of telehealth makes it possible to enter their world without interfering with it.
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8-20-2015 - ADOPT A RURAL HOSPITAL/ CLINIC
Every day as we travel the US highways and roads, we pass "Adopt a highway" signs that ask organizations and community groups to adopt and care for a section of that highway and keep it clean. It would be a great idea to have major medical centers, hospitals and schools to adopt a rural hospital or clinic, in similar fashion. Bring them under their umbrella and see to their care and success. Many such arrangements are in the works right now but it usually is to send interns and residents to these rural community clinics on rotational basis. Although this is great, it benefits the rural communities, minimally.
Our rural clinics and hospitals deserve more than just receiving students. They deserve a full fledged support system. By every major medical institution adopting a rural health center, state of the art healthcare could be brought to these areas to the benefit of everyone.
Today's technology and communication system, makes such adoptions not only possible but profitable. I am sure that legal minds and bean counters can find all kinds of ways to bring revenue to the majors through this support system, and in the process, real, timely, and proper care is provided to our rural communities. Lets adopt our rural hospitals and clinics and provide them the support system they deserve. Telehealth can help us do exactly that!
8-13-2015 Osteopathic Medical School in NM
Our recent meetings with the leadership of NMSU and Burrell College of Osteopathic Medicine has been heartwarming and welcomed as more needed healthcare help comes to New Mexico. However, it is disappointing to hear that the majority of the more than 2000 applicants for the 200 positions are from out of state. Many New Mexicans still are not aware of this new school. Out of state students usually leave after their studies conclude.
We would like to see more New Mexican students apply to this new program, especially those from our minority communities such as Native American Tribes and our Hispanic population. We encourage NMSU and the Burrell College of Osteopathic Medicine to promote this program to our minority students. We further encourage them to seek and establish scholarship programs to help these students pay for their schooling. New Mexico's Lottery system and money available from the casino gambling could be made available with little effort.
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8-6-2015 - Meeting with NMSU President about The new DO School in NM
On Tuesday, August 4th, several of the New Mexico TeleHealth Alliance Board members had the honor of meeting with President Garrey Carruthers of New Mexico State University. The role of telehealth and the future of healthcare at NMSU was discussed. Many exciting new programs are being started at NMSU, including the Burrell College of Osteopathic Medicine, and several of the existing programs are being expanded, re-designed, and improved like the BSN program in Alamogordo. President Carruthers was adamant to point out that no public money is being used for the development of the new osteopathic school at NMSU. The entire 100 million dollar project is being funded by private investment and donations.
It was heartwarming to see that president (and prior NM governor) Carruthers is excited about the healthcare programs at NMSU and the future of healthcare, use of telehealth, telemedicine, and prospects of increasing the role of mid-level providers in NM. The New Mexico TeleHealth Alliance looks forward to working with NM State University in starting, expanding and improving their healthcare programs, including the new Burrell College of Osteopathic Medicine. We feel that the leadership of people like President Carruthers is what makes New Mexico such a great place to live and why we at the Alliance are so excited about the future of health in our state. We encourage all of our young people, especially our Native American and Hispanic students to look into a carrier in healthcare at NMSU and the many other fine schools of higher education in our state.--
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7-23-2015
As telehealth and telemedicine grow exponentially, many opportunities and problems surface that challenge the very foundation of the trade. While the technical and industrial side of this business grows, the disparity between the suppliers of telemedicine and the receiving public widens.
As usual, a great hurdle to this process are the regulatory agencies of our government. One such major obstacle is the licensing process of those who practice telehealth. Nowhere is this problem more acute than in the western states, where many rural boarder communities use the nearby medical facilities of the neighboring state.
Several organizations such as the American Telemedicine Association (ATA) and Federation of State Medical Boards (FSMB) are working to alleviate or at least streamline the process of interstate licensing. The NM TeleHealth Alliance is one such organization involved in this process. At the present time, the Alliance is chairing the "Four Corner Telehealth Consortium". Since the interstate telehealth has been an important issue for many of us, it was discussed at the last ATA annual meeting in May, and it was decided to expand the consortium to the "Interstate Special Interest Group (SIG) in order to have an input from the entire country. However ATA's own regulation requires the development of an interim subcommittee as a stepping process to ensure the necessity and viability of the SIG. Thus "Interstate discussion group" (IDG) has been developed and New Mexico along with the other Four Corner members; Arizona, Colorado and Utah are working toward this transition. We are hoping to present our findings to ATA at the next year's meeting in Minneapolis.
In this regard, we would appreciate any input from our membership regarding their involvement in any interstate or multistate telehealth activities.
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7-16-2015
Last year about this time, the chairman of Federal Communication Commission (FCC), Tom Wheeler came here to Albuquerque and met with us to discuss ways to improve access to unrestricted affordable high speed broadband internet for all New Mexicans, and here we are a year later and not much has has come our way from the Feds. However, the NM TeleHealth Alliance has been very busy in moving telehealth forward in NM.
At the present time, there are serious efforts being made to transfer responsibility of the consortium; the Southwest telehealth Access Grid (SWTAG), from the FCC Rural health Care Pilot program from UNM to the Alliance. Many healthcare provider organizations are willing to pay to provide access to health care services, telehealth and health information exchange for the communities of our State including tribal communities. The FCC’s new Healthcare Connect Fund provides 65% of the cost for building, enhancing, and operating network infrastructure for healthcare, particularly for rural and frontier communities. In the end the need for affordable connectivity and access to the internet should address all community needs including access to education, training, news media, economic development, as well as healthcare. The government wants this to be managed by a non-profit organization, such as the Alliance. However, finding an appropriate organization to take on this challenge has been daunting as no money is available to manage it. Since there are funds available through the Healthcare Connect from FCC to improve networks for broadband for healthcare, the Alliance is looking to ways in using this fund to get the ball rolling and to expand broadband networks for healthcare, and taking responsibility for the SWTAG.
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7-9-2015 - Rep. Thompson bill removes barriers to medicare’s Telehealth coverage
The American Telemedicine Association (ATA) supports legislation introduced by U.S. Rep. Mike Thompson (D-CA 5) that will provide payment parity for an expanded list of telehealth services available to Medicare beneficiaries. Thompson’s bill, the Medicare Telehealth Parity Act, was introduced with bi-partisan sponsorship from Representatives Gregg Harper (R-MS 3), Diane Black (R-TN 6) and Peter Welch (D-VT).
“This bi-partisan legislation introduced by Rep. Thompson takes an important step forward in removing artificial restrictions to telehealth access for millions of Medicare beneficiaries,” said Jonathan Linkous, of ATA. “ATA supports this legislation because it supports our mission to ensure parity for telehealth technology in the delivery of care."
New Mexico providers should call their representatives and senators and ask them to support this bill (H.R. 2948).
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7-2-2015 - The Declaration of our independence
"We hold these truths to be self-evident, that all men are created equal, that they are endowed by their Creator with certain unalienable Rights, that among these are Life, Liberty and the pursuit of Happiness, ...."
As the above declaration states these rights, perhaps the right to Good Healthcare should have also been included. Today as we continue to struggle with this issue, the technology of TeleHealth could make it possible for all mankind everywhere to get proper healthcare.
HAPPY 4th OF JULY
OUR
INDEPENDENCE DAY
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6-25-2015
Gov. Susana Martinez signed a Special Session Capital Outlay Bill (SB 1) this week that includes $5.3 million in funding for the Domenici Center for Health Sciences Education. It will add 85,700 square feet of large classrooms, laboratories, simulation, and student study space to support the colleges of Nursing and Pharmacy, and the School of Medicine. Construction is expected to begin early 2016, and classrooms should be open in the summer of 2017.
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6-18-2015
On Tuesday, June 16, New Mexico Department of Health held a summit on Telehealth at UNM Cancer Center. The primary report from consultants; Pod & Associates identified that there are a significant number of different telemedicine programs in our state and better coordination of telehealth programs and facilitation of them is needed if we are to get maximum benefits from the money spent. The NM Telehealth Alliance has been promoting this concept since it's inception in 1996.
"This is the future." said Dick Govatski, CEO of Net Medical Xpress, "This is what we need to be telling the people over and over again. We can’t keep doing it the same way and expect health care costs to decrease."
Gar Clarke, the director of the State of N.M. Broadband Project noted that there is "a need for intersection of public organizations and the private sector." However since telehealth is still a relatively new concept in the public's eye, there is a lot of misunderstanding with regards to education, training and implementation of telemedicine technology. Reimbursement can vary from state to state and coverage of telemedicine services by Medicare, Medicaid and insurance carriers isn't consistent across the country.
The stake holders at the summit agree that many challenges face the telehealth providers in our state. But since access to telehealth benefits patients and the economy in the rural areas of our state, it is important to resolve the problems facing it. A formal assessment of the needs will be presented to the Department of Health, hoping that by identifying them a solution will soon be found.
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6-4-2015
It's summer time and as we venture outdoors, allergies and environmental reactions cause havoc on some of us. It is a malady many of us deal with on a regular basis. It is interesting that our advanced and modern medicine has not been able to eradicate this problem and if anything, our industrial world has drastically contributed and added to it's challenges. Looking back on the history of allergies, we see that it has always been perplexing to the medical practitioners.
The earliest known report of an allergy was that of King Menses of Egypt, who died after a wasp sting around 3500 BC.
Roman philosopher Lucretius noted that "what is food for some may be fierce poisons for others."
Shen Nong (c. 2700 BC) - considered the Father of Chinese Herbal Medicine - was the first to use ephedra to treat asthma-like symptoms five thousand years ago. While Frankincense, yellow ochre, and grapes were used to treat respiratory symptoms in Egypt around 3000-1200 BC.
Hippocrates (c. 460-377 BC), was one of the earliest physicians to understand the link between respiratory ailments and the environment.
The Talmud (old testament) discusses the use of "hiltith," the Arabic word for asafetida, for prevention and treatment of asthma, whooping cough, and bronchitis.
Indian treatment of allergies, like smoking stramonium, for the treatment of asthma was practiced by the British army physicians for many years.
In the new world, dried root of the ipecacuanha, which is a natural expectorant, and balsam was used by Native Americans and taken back to Europe by Columbus and is used in cough medicines to this day. The ancient Americans also used ephedra and cocaine to treat rhinitis and asthma.
It's fascinating to note how remarkably advanced our ancient forefathers were in their understanding and treatment of allergies, yet the modern era of allergies didn't begin until the nineteenth century when hay fever was first described. Today many of the same challenges remain.
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5-28-2015
Last Monday was Memorial Day, when we remembered all those who gave their lives to defend our country. It's noteworthy that a year after the end of the Civil War, in April, 1866, four women of Columbus, Mississippi gathered together to decorate the graves of the Confederate soldiers buried in their town. They also felt moved to honor the Union soldiers buried there, and to note the grief of their families, by decorating their graves as well. The story of their gesture of humanity and reconciliation is now told and retold in Mississippi as being the occasion of the original Memorial Day.
We should remember however that many in that war and since have lost their lives by receiving improper care in the hospitals after they were wounded. Medicine has always played a big role in military history. On May 19 in 1822, for example, the first naval medical school was opened at the Philadelphia Navy Yard to train physicians to care for the special needs of sailors and soldiers, yet we lost many of our wounded in the wars that followed.
Throughout history, as armies grew and weapons improved, the care of the sick and wounded became increasingly important. Cleanliness kept pestilence away in the Roman Army. The Roman soldiers bathed regularly even when on campaign. Cleanliness was recognized and reduced the incidence of wound infection. Acetum or vinegar was used extensively in wound cleaning by Roman physicians. A practice that continued for a long time but was lost during the Dark Ages.
Florence Nightingale and her trained nurses re-introduced basic standards of hygiene and sanitation thus lowering the mortality rate from 44 percent to 2 percent by the end of the Crimean war.
Today's militaries are equipped with the state of the art technology to attend to the sick and wounded. Telehealth and telemedicine is increasingly used to bring help to the battle fields and field hospitals. Yet back home our veterans lack proper care in many rural communities. Expansion of Telehealth and telemedicine could help reduce the hardship of many of these veterans.
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5-21-2015 - Ebola diaries: Lessons in listening
Cheikh Ibrahima Niang, a professor of medical and social anthropology at the Cheikh Anta Diop University in Dakar, Senegal, was asked by the World Health Organization (WHO) in July 2014, to investigate community attitudes to Ebola virus disease. His report was published by WHO last February. Read his full report here;
The most important thing he learned was that too many people from other countries went to these disease stricken areas and told the people there what to do. But no one was listening to what the locals had to say. Dr. Niang's first assessment was that before you can create effective messages, you have to listen first. People needed to be heard and given the knowledge that gives them the power to make their own decisions.
"So we did a lot of listening, without making any noise." He said, "Our approach was humble, human, discreet, focused on their concerns. No official cars, no flag waving, no uniforms. We did not make a show. In fact, WHO was the only organization that sat with villagers and listened to them for hours. And they were anxious to speak with us. Angry, frustrated, scared of this disease that was killing them and of these recommendations that clashed with their belief systems, they felt misunderstood and abandoned by the whole world.
It became clear that resistance was a way people affirmed their position when their dignity felt threatened. Once heard and understood, communities felt reassured, violence diminished and as they felt that their dignity and trust was restored, we were well received."
There is a great lesson to be learned here. It is no different here in our country. As the demography of our world changes, rural communities become more isolated and alienated. Often even forgotten. Then when disaster strikes, all kinds of people converge on them with all kinds of ideas. Too many messages have a way of being misunderstood and ignored. A good example of this was the chaos people experienced during Katerina. Many agencies and organizations were conveying conflicting information. The end result was that thousands of people were left without any help.
Today we have the gift of tele-education and telehealth. Proper use of these technologies can keep the people everywhere informed, educated and prepared for future calamities, epidemics and disasters. To use the old vernacular; "an ounce of prevention is worth a pound of cure." Telehealth can do that effectively, cheaply and timely.
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4-16-2015
It is interesting that as telehealth and telemedicine get more acceptance and prove to be viable and cost effective, different states, organizations and practices act upon it with divergent viewpoints. Case in point is the recent ruling of the Texas Medical Panel (see the NY Times article bellow.) This in part has to do with people's perception and expectations of this relatively new technology and their distrust of the insurance industry and organized medicine.
Licensure Portability is a key component of telehealth. Without it the essence and principle under which telehealth and telemedicine work will be lost. For, the real places where telehealth is needed are the rural communities of our country. Many of these rural towns are on the boarder of neighboring states. License portability is essential in these boarder state clinics and hospitals. Although many states like New Mexico have passed regulations allowing for telehealth licensure, they still resist portability of full medical licensure.
The availability of state of the art medical technology changes with the demographics of our population. Shortage of adequate specialists in the rural areas and lack of funding to operate smaller medical establishments necessitate the use of telehealth and telemedicine. So sooner or later, barriers will have to be lifted and the use of this new way of practice accepted in order to provide proper care to all.
Recently CMS approved the use of telehealth, the Federation of the State Medical Boards is pushing toward license portability and with expansion of the so called "Doc in the Box" clinics through major retailers such as Walmart and Wallgreens, it will only be beneficial to resolve these issues early. The New Mexico TeleHealth Alliance fully supports and indorses Licensure Portability.
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3-26-2015
Today is the birthday of poet Robert Frost, born in San Francisco (1874). Frost was a farmer before becoming a famous poet. He said; "when I took a trip to New York City to try to interest editors in my poems, I was too much of a farmer, I had mud on my shoes. They could see the mud, and that didn't seem right to them for a poet." In 1911 he sold his farm and moved to England. Several months after arriving in England, Frost published A Boy's Will (1913) and then North of Boston (1914), which sold 20,000 copies and made him famous. Frost won the Pulitzer Prize for poetry four times. He said, "In three words I can sum up everything I've learned about life: it goes on."
As it was with Frost's muddy shoes, people's expectations are based on their perceptions. Our patient's expectations demand that we help their lives go on healthily and painlessly. Even if that is not possible, if we give them the impression that we care about their well-being, it will ease their pain. Often that can be done by just listening to them. The good Lord has given us one mouth but two ears. If we listen twice as much as we talk, we will make our patients very happy. Telehealth is a great tool that allows us to listen to our patients, near and far. We can thus be effective, productive, and opportune in our efforts to address our patients' concerns, which is what we are there for in the first place!
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3-5-2015
It can be said that telehealth and telemedicine have grown out of infancy and are in their toddler stages now, which makes it important to instill good and proper habits into their practice.
Like many technologies, big business sees the economic potential in this venue and has moved in to control and direct the practice. Although business contribution is essential and needed, we must not forget that the true need for this new and wonderful tool is to serve the people.
The greatest benefit to mankind in the use of telehealth is the ability to bring needed healthcare to areas of the world in conflict, or inaccessible or dangerous to healthcare providers, etc. Most of us in the provider side of this technology voluntarily apply it to our practices. Organizations such ATA and United Nations' World Health Organization (WHO) and our own UNM's Project ECHO use telemedicine and telehealth in such areas on a daily basis. Potentially risky and dangerous areas such as the medical problems of radioactivity in places like Three Miles Island, Fokoshima and Chernobyl are a good example of this use. The Chernobyl Telemedicine Project is one such project established by WHO.
Many conflicts can be eased and even eliminated by the use of telehealth in places with humanitarian crisis. Advanced countries in medical sciences such as US, EU, India, Israel, and China could help needy parts of the world such as Latin America, Eastern Europe, Bangladesh, Gaza, and Tibet respectively without actually having to send their providers there. The goodwill can heal most animosities and open doors of friendship. Let us instill this practice as a habit into our toddler. Lets have telehealth and telemedicine bring real peace and kindness to our world.
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2-19-2015
I am going to venture that the man who sat on the ground in his tipi meditating on life and its meaning, accepting the kinship of all creatures, and acknowledging unity with the universe of things was infusing into his being the true essence of civilization.
Luther Standing Bear (1868? - 1939)
Oglala Sioux chief
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2-12-2015
It is indeed great news to learn that construction has begun on the $105 million Burrell College of Osteopathic Medicine. The new school will be at Arrowhead Research Park on the campus of New Mexico State University in Las Cruces, NM.
With the need for providers growing daily and new laws requiring everyone to have health insurance, one of the best ways to meet this need is to train and educate new doctors and healthcare providers. UNM has been training healthcare professionals since before New Mexico's statehood. But in recent years our population has exploded and will continue to do so in the foreseeable future. Our great weather and healthy environment is a magnet for the baby boomer retirees and Southern New Mexico is the preferred location for them. Thus the demand for providers will only increase with time. It is good to see that this need has been foreseen and now steps are being taken to address it.
As part of this new education system, we at NM TeleHealth Alliance feel that telehealth will be playing a big roll in educating and providing healthcare at our new medical school facility. Thus we congratulate the new Burrell College of Osteopathic Medicine in this endeavor and will help in anyway we can to ensure their success.
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2-5-2015
According to ATA, state legislatures have made telemedicine a priority issue for 2015. Ten states have introduced legislation that will impact the way your licensing board enforces its clinical practice standards: Arizona, Arkansas, Connecticut, Montana, New Hampshire, New Mexico, Oklahoma, Virginia, West Virginia and Wyoming. Six states have bills that will require telehealth parity under private insurance: Arkansas, Connecticut, Indiana, New Jersey, Rhode Island, and Washington.
2015 State Telemedicine Legislation Tracking------------
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1-29-2015
As you may have noticed by the number of unsolicited calls you are getting daily, this is open enrollment time for national healthcare or Obama-care. However, one area of this process that is not being adequately addressed is the shortage of providers. Especially in the rural areas of our country. Here in New Mexico, our Governor Martinez did not even mention healthcare in her 'State of the State Address' to the legislators last week. Is that an indication that our government is at a loss in dealing with the problem?
As we have been hammering this issue, TeleHealth and TeleMedicine along with TeleEducation are the answers to this dilemma. Computer technology of the twenty-first century is creating and providing communication avenues that could bring help to everyone. The information provided through this technology along with clear, concise and accurate consultation will allow Physician Assistants (PA), Nurse Practitioners (NP), Pharmacist Clinicians (PC), Dental Therapists (DT), and other so called mid-level practitioners to provide excellent routine and preventive care to everyone, everywhere.
The Legislatures are meeting right now. This is the time to contact them and ask that they pay attention to and pass legislation to divert this crisis. Here is the link to the NM Legislature.
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1-22-2015
Our world is getting smaller and smaller. As the population grows and mobility becomes ever so commonplace, diseases grow and spread more rapidly. Today many of once believed contagious illnesses are showing their menacing faces again. As we seen in it the recent measles at Walt Disney World in California and Ebola outbreak in West Africa. These problems do not limit themselves to any particular geographical area. That is why there are epidemics. New Mexico Department of Health has guidelines on how to deal with many of these issues. But more importantly we should note that TeleHealth can help in controlling these epidemics and pandemics.
Learn how TeleHealth can play a role in these cases. More importantly help your legislators understand the role of TeleHealth in controlling the spread of diseases and ask them to support TeleHealth legislations.
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1-15-2015
The New Mexico Legislature begins on Tuesday January 20.
The new legislators, along with the old, will need to be educated on healthcare issues. It is important that they learn about these issues from those of us who deal with it on a daily basis, and not from opposition lobbyists. Please watch the bills being presented and contact your legislators with your input.
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1-8-2015
While many states struggle to integrate telehealth into their system, New Mexico has one of the broadest rules and regulations for the use of telehealth in the nation. Other state telehealth organizations call us for guidance and advice in setting their rules. In spite of this, many of our own practitioners do not use telehealth in their practices.
NM TeleHealth Alliance provides many benefits to it's membership. In a recent meeting NM TeleHealth Alliance worked on drafting a means to open membership to anyone interested in joining it. As an example of benefits, all members of the Alliance are automatically members of the American Telemedicine Association (ATA) - a $220.00 savings over joining ATA as an individual member. ATA offers enormous resources to it's members, including a wealth of educational courses and online webinars, meetings and travel savings, regulatory help and guidance. Consider joining NM TeleHealth Alliance in the coming year and let us help you expand and grow your practice in ways that you did not know possible.