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Telemedicine could bring specialists to rural health care

LANSING — Advocates for an increase in online-based health care — telemedicine — say it would help residents in rural areas who need specialists, but a lack of internet access is slowing them down.

Telemedicine is the distribution of health services via electronic communication and videoconferencing. The American Association for Retired Persons, with a Michigan branch headquartered in Lansing, has called for increased access to telemedicine for its members.

According to Mark Hornbeck, AARP’s associate state director for communications, online doctor visits would give older adults better access to health care.

“Especially in rural areas, we have a lot of older adults who are miles away from a doctor’s office,” Hornbeck said. “For routine check-ups and even semi-emergency situations, it would be a lot more convenient for them to contact a doctor on their computer as opposed to finding someone to get them to a doctor’s office.”

AARP supports a recently passed House bill that would increase the ability of out-of-state nurses to practice telemedicine in Michigan. The bill, sponsored by Reps. Mary Whiteford, R-Casco Township, and Tommy Brann, R-Wyoming, is pending in the Senate.

According to Whiteford, the bill would add Michigan to the multi-state Nurse Licensure Compact, allowing registered nurses from other states to provide telehealth services to patients in Michigan without having to obtain another license.

“I’ve been hearing for years about the challenges that health care providers face, and a huge one is when we have a lack of professionals,” she said.

Thirty-one states already participate in the inter-state licensing program.

According to a House Fiscal Agency analysis, opponents of the bill say that entering the nursing license compact would make the process more complex and could lead to a lower quality of medical care due to differences in training requirements for out-of-state nurses.

Whiteford disagrees that the bill could lower the quality of care.

“The big challenge is that the Michigan Nurses Association came out against it and said it was going to decrease the quality of nursing,” Whiteford said. “But as medical need has increased across the state, we have found that there is a huge need for the nursing compact to help out, both in person and by telemedicine.”

The association is an Okemos-based labor union representing nurses across the state.

The bill would open up options for nurses, according to Kathy Berchem, an associate professor and chair of the School of Nursing at Lake Superior State University.

“When students graduate here, they have to take the National Council Licensure Examination Board exam once,” Berchem said. “If a nursing student wants to take an exam in Michigan, they’re only licensed in Michigan, and that’s it.

“If they want to travel somewhere else and work, they’re going to have to pay a state licensing fee that’s anywhere between $100-$300, which has to be renewed every two years,” she said.

According to Berchem, increased options for nurses could lead to more medical options for Michigan residents.

“It’s more attractive for students coming into nursing school knowing they have the option to go anywhere,” Berchem said, “and when they graduate there are more opportunities for nurses to go where the need is, which is good for everybody.”

Lake Superior State practices telemedicine with its nursing and paramedic students at the Superior Simulation Center.

“We have some portable telemedicine devices that each of our students go through training on,” Berchem said. “Our local hospital has the same devices, so we train our students to use these devices for telemedicine so they can function as health care providers.”

According to AARP’s Hornbeck, however, access to providers isn’t the only barrier to providing telehealth services.

“Part of our lobbying includes more access to broadband in Michigan because you can’t access telehealth without it.” Hornbeck said. “More than a quarter of adults in Michigan don’t have access to broadband internet, and for those over 65 that number jumps to 51%.”

According to Connect Michigan, a nonprofit group advocating for increased internet access, nearly 381,000 homes across the state have no to broadband.

Broadband is defined as a high-speed internet connection, and Michigan ranks 30th among the states and territories in its availability. According to Hornbeck, lack of access is mostly in less urban areas, the same places that lack medical specialists.

“It’s mainly a problem in rural areas,” Hornbeck said. “We have a lot of retirees who live in Northern Michigan, and it’s a geography problem with limited access in those areas.”

According to Connect Michigan, 97%, or 368,000 of the 381,000 households without access, are in rural areas, particularly in the Upper Peninsula.

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