Indian health Services expand telehealth care for patients

Image
  • Telehealth Care
Body

With its community health representative program suspended due to COVID-19, western Oklahoma’s Indian Health Services direct care facilities are expanding their use of telehealth.

In late March, IHS issued additional guidance that allowed clinicians to use certain additional, non-public facing audio or video communications technologies to augment all clinical activities related to providing care to patients during the COVID-19 public health emergency.

The expansion applies to telehealth provided for any clinical reason, regardless of whether the patient visit is related to the diagnosis and treatment of health conditions related to COVID-19.

Along with Claremore Indian Hospital and three IHS facilities on the Navajo Nation’s reservation, Lawton Indian Hospital and the Clinton Service Unit participated in a pilot program in late March and early April to expand telehealth services via an encrypted audio/video system. The Clinton Service Unit also includes clinics in Watonga and El Reno, while Lawton Indian Hospital’s service unit includes the clinics in Anadarko and Carnegie.

The actual program officially rolled out nationwide on Thursday.

“We are trying to take care of patients’ needs over the phone or via video call whenever possible to allow them to maintain social distancing and to minimize the risk for elders,” Clinton Service Unit Clinical Director Dr. Sarah Hartnett said.

At a telephone town hall meeting Friday, Hartnett walked attendees through he process and acknowledged that with limited broadband capabilities in some communities, the process still has some kinks.

When a patient contacts their primary care provider to schedule an appointment, they will automatically be asked about their phone and internet access to help determine whether a telehealth appointment is feasible. If the patient has reliable access and is not facing a life or death emergency, then efforts will be made to see him or her remotely rather than in-person.

“It is a work in process,” Hartnett said. “Sometimes there are still some technical issues.”

IHS facilities in the Oklahoma City Service Area, which includes part of Texas and all of Oklahoma and Kansas, have administered 1,797 COVID-19 tests as of Wednesday, trailing only the Navajo Service Area.

In addition to the sites offered through local health departments, the Clinton Indian Health Center has drive- through COVID-19 testing available from noon to 2 p.m. Monday through Friday for patients who already have an established chart and are exhibiting symptoms.

Demographic data on confirmed COVID-19 patients has been scarce, both locally and nationally.

“I’m not seeing any trends that suggest American Indians and Alaska Natives are at greater risk...beyond pre-existing socioeconomic factors,” Dr. Darryl Cox said.

According to partial data released on Thursday by the state Department of Health, American Indians and Alas- ka Natives account for 6.8 percent of Oklahoma’s confirmed cases and 5 percent of the state’s fatalities. However, about one-fifth of those reported cases did not include racial or ethnic information.

Further skewing the data, a spokeswoman with the state Department of Health confirmed on Friday that Oklahoma’s testing data does not include tests administered at IHS facilities.

However, Indigenous adults are more likely to independently have several of the risk factors, including diabetes, lung disease and heart disease, thus prompting medical staff to encourage people with pre-existing conditions to keep them in check.

“It is more important than ever that people try to keep their diabetes under control right now,” Hartnett said. “Please have your necessary medications on hand, keep your blood sugars under control, get walks in when you can and eat healthy through this.”