Dr. Giannoni believes that technological improvements will open up more options for telehealth. She underscored the fact that equitable access to technology is critical to ensure that all patients can get to the technology platform and know how to use it. A recent survey found that providers listed connectivity and the ability to navigate the technology as the main patient concerns with telehealth, and the issues that most led to frustration for patients and families (Ann Otol Rhinol Laryngol. 2021;130:788-795).
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February 2023A Hybrid Model of Care
One strategy to overcome some of the current technological limitations of telehealth is to use a hybrid model of care in which patients and families engage in a telehealth visit at a remote site with a local allied medical professional.
At Nemours Children’s Health, pediatric otolaryngologists use satellite clinics called provider-assisted telehealth. Patients and their families travel to one of these clinics where they join a local medical assistant or an advanced practice provider in a telehealth meeting with the provider. “The assisting provider utilizes a video cart with a peripheral video otoscope and camera that allows us to perform a more complete exam,” explained Dr. Barth. “This allows families to receive local care and saves the specialist from having to travel to distant satellite clinics. It also allows for the specialist to cover several satellites from a single location.” During the first six months of 2022, 325 provider-assisted telehealth sessions were conducted at Nemours, of which 112 were in otolaryngology, according to Dr. Barth.
In addition to helping providers conduct a more detailed exam, meeting with patients and families at a satellite office helps mitigate technological glitches, such as slow home Wi-Fi or a lack of access to the technology required to use telehealth.
Improvement in technology is needed to boost the effectiveness of telehealth visits, but Dr. Gerber says he looks forward to ongoing improvements in the capacity for images and possibly video, in the ability to take and transmit vital signs, and in the ability to auscultate lungs and hear sounds to help make diagnosing pathology easier.
Mary Beth Nierengarten is a freelance medical writer based in Minnesota.