Telehealth and Diabetic Retinopathy in Kentucky

Part 2 of my report on the Health Enterprises Network presentation last week is a focus on, if you can imagine it, perhaps telehealth can do it. Rob Sprang has been the director of Kentucky TeleCare at the University of Kentucky Chandler Medical Center since 1996, and program manager of the Kentucky TeleHealth Network (KTHN). It is under his leadership that the issue of blindness from untreated diabetic retinopathy has been tackled in rural Kentucky Counties. The amazing thing is that the technology is now available, affordable and in use. If detected early enough, diabetic retinopathy does not have to lead to blindness. 50% of diabetics in rural Kentucky do not consult a physician, even though diabetic, and even though a screening would prevent blindness. Bringing the doctor to those folks will make a difference, not only in their lives, but in the lives of their caregivers and in the utilization of the system.

Sprang serves on the board of CTeL Innovations as well, and is active in trying to remove obstacles to using telehealth in our reformed healthcare delivery system. Since our current medical system and licensure are location specific, the addition of telehealth causes issues. One obstacle to overcome is credentialing, and credentialing by proxy is the preferred solution. It is only through perseverance and a focus on the value that telehealth brings that these obstacles will be overcome and telehealth will become a viable component of our system.

Funding is always an issue. Our health care system is so based on reimbursement that many services are based on reimbursement, not what the patient needs. We walk a fine line between serving the populations’ health needs, and getting reimbursed to provide services. Utilizing telehealth in a variety of settings is a disruptive technology that will change how health care is delivered, the reach of specialists, and the outcomes for patients who need ongoing monitoring, or have a disease that requires a medical professional to make decisions to care on a sporadic basis.

Moral to this post is, think about telehealth as just another option to put on the table to expand our scarce human resources as we start to see the numbers from the age wave climbing, and as services become more scarce.