The Georgia Health Policy Center recently spoke to Litia Garrison, the senior director of planning and development for the Southeast Alaska Regional Health Consortium based in Juneau, about how the consortium was able to develop a telehealth system to serve 25 communities in southeast Alaska through the pandemic and beyond. 

 

To date, what has been the biggest accomplishment or win in your COVID program?  

Over the course of two years of the pandemic, we were able to pivot from using telehealth only occasionally, to building out much more robust telehealth capacities. We took stock of what we had available in house and quickly assessed what we wanted to do differently in order to open up access again as quickly as possible via telehealth. 

Then, we focused on planning and adopting a much more deliberate and dedicated program to bring as much care as close to home as possible. I know it sounds a little cliché, but necessity is the mother of invention. With the support from FORHP and the need for quick innovations to navigate through the early stages of the pandemic, we essentially stood up what is now the beginning of a very robust telehealth program. We were able to take the idea of the old-style telehealth computer cart and basically turn the experience into a tablet-enabled, face-to-face encounter. 

 

What is a tip or learning that you would share with another tribal organization?  

The first learning is that not every solution can be adapted or rolled out across all of our communities. Our initial idea was to send workers out into the communities to act as health technicians, taking the new equipment to patients at their homes to facilitate the telehealth encounter. But early on in the pandemic, not all of our community members were comfortable with the idea of interacting with someone outside their household “bubble,” even to conduct a telehealth encounter at home.  

One other lesson is to make sure that your organizational and programmatic agenda is driving the timing and the conversation with the technology sales folks. Yes, vendors have a business to attend to, but make sure the focus stays on the patient care you desire, your community needs, the timeline, and with the resources that work for you. 

 

How do you see participation in the Federal Office of Rural Health Policy’s COVID-19 grant program impacting your broader telehealth or health improvement efforts? 

We feel we were really able to move the dial on expanding options for delivering care closer to home. That is an important element of our strategic plan because we are so geographically dispersed as an organization. To be able to provide as much primary health care and specialty care as close to home as possible makes sense for the patient and the organization.  

We implemented a pilot program with a remote ultrasound device that we can use in our clinics. The remote device allows for live studies, cloud storage, integration to our EHR, and review by other providers for continuity of care. Building on that success, at the very end of the FORHP project, we purchased some remote ear-nose-throat devices. Again, the goals are to provide care in the patient’s home and community when appropriate, thus decreasing the need to travel patients when it makes sense for the patient, which can be time consuming and less convenient for the patient. It is a win-win for us and for the patient. 

 

What will your organization be doing more of or differently to emerge stronger from the pandemic? 

I mentioned earlier that we are moving forward with a very deliberate, structured plan to build a telehealth program as a service line. Before the pandemic, we may have thought of telehealth as less optimal than an in-person encounter. I think what we have learned in the pandemic is, that is absolutely not the case. Our telebehavioral health volumes increased significantly from the beginning of the pandemic to today, and they continue to remain very high. Compared to other medical specialties, behavioral health accounts for a high proportion of telehealth encounters across the organization, and I see that continuing. 

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