Keep improving telemedicine and distance learning | Guest View

 

Last updated 7/2/2020 at 9:56am



As America’s iconic newsman Edward R. Murrow proclaimed, “There’s no substitute for face-to-face communication.” That said, the current pandemic has forced us to rely on the next best thing: communication and service delivery via the internet.

Remote services for medical checkups and education have for years benefited people living in remote locations, those who lack access to transportation, are too frail or vulnerable to participate in-person, or are in institutions such as prisons or the military. Online shopping has expanded and improved daily.

There will be future disruptions to face-to-face contact. Earthquakes, more pandemics, nuclear fallout. The list goes on. Assuming the power grid and internet survive future disasters, we will once again rely on remote systems while sheltering in our homes.

In my recent experience, neither telemedicine nor distance education worked smoothly at first. My first telemedicine checkup started 45 minutes late, both on my end and my doctor’s.

Though my doctor didn’t request it, I gave him my blood pressure.

With distance education, our two grandkids’ teachers in Edmonds scrambled to find materials that lent themselves to on-screen communications. Their first few sessions were uneven, and it was hard to navigate among the work assignments, and I was not used to the computer being used.


These areas improved over time. Some teachers offered virtual daily class meetings; others met weekly, with short daily tutoring sessions in math.

Some suggestions for improvements:

Using the technology has to be easy! Online sessions, by their nature, are usually time-limited. Like rocket launches, they have work right when you flip the switch. Are the service providers – medical and educational – fluent and comfortable with computers? Is technical support readily available to them and the end users?

What about language and cultural barriers? Do the service recipients speak English? Is real-time translation service available? Can a social worker be of use?

On a basic level, the technology should ensure clear graphics, use of multiple images simultaneously, and avoid time lags in speech. Do the recipients have functional computers and internet service? Are all the clients using Wi-Fi?

Some Edmonds schools loaned inexpensive laptops to students. All school districts should do the same. Could medical clinics loan basic laptops to patients, possibly underwritten by Medicare, Medicaid or private insurance?

Future systems in both telemedicine and distance education must be flexible enough to address the needs of each individual. Health-care providers and schools should seek input from all who have been on the front lines, including students.

Schools should actively seek out and speak with single parents and parents of multiple children who juggled work with their children’s distance learning, and – especially – interview families who have been left out entirely.

In telemedicine, the Centers for Medicare and Medicaid (CMS) and insurance companies must pay medical practitioners for on-screen visits, not just face-to-face as in the past. State governments and medical groups must consistently legalize the practice of medicine across state lines.


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To make telemedicine more comprehensive, patients at home could use inexpensive kits to measure blood pressure, temperature, blood oxygen saturation, blood sugar, and weight. A more advanced kit could include body sensors to take and transmit measurements in real time to physicians.

Urine and other samples could be taken and analyzed at home or delivered to clinics.

In distance education, there should be a computer screen or direct phone line to a teacher’s aide, who can help with technical questions and assist students who need it.

All material, whether hand-drawn or created on the home computer, should be easily uploaded. Students and parents should be able to track what has been submitted by the student and know what remains to be turned in.

Clear and consistent goals and objectives must be developed for online learning, with testing and grading. An added feature might be small-group breakaways for students to do team projects and socialize. Zoom and other private companies will hopefully add features giving online learning added appeal.


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As users, please give constructive feedback to your medical providers about telemedicine and to schools about remote education. Above all else, urge elected officials to provide ongoing, reliable funding for further perfection of these systems.

While we’re at it, let’s push for fortifying the power grid and the internet system. Not just our sanity, but our lives, will depend on them!

Cliff Sanderlin wrote grants for telemedicine at the University of Washington School of Medicine and distance learning grants for school districts and a community college. He directed foundation relations at Fred Hutchinson Cancer Research Center. Now retired, he lives in Edmonds with his wife, one adult son and two grandchildren.

 

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