In telemedicine, some say Berkshire County being left behind

BOSTON — Massachusetts legislators appear to be on the same page in facilitating telehealth and telemedicine in the commonwealth. At least in the eastern part of the state.

Telemedicine might include email communications between a patient and a doctor, remote patient monitoring using devices that transmit the patient's health status to a distant doctor, and live interactive conversations using any kind of video apps.

"While telemedicine is an excellent strategy and I think we should use it more," said Rep. Tricia Farley-Bouvier, D-Pittsfield, at her Statehouse office, "it is not going to work unless you have the underlying infrastructure of broadband to all parts of the state, and right now a significant portion of the state lacks broadband."

The House version of telehealth and telemedicine bill was presented Tuesday by Rep. Paul Brodeur, D-Melrose, before the Legislature's Committee on Public Health. The Senate has the identical version of this bill, filed by Sen. Michael O. Moore D-Millbury.

"I believe telemedicine is a way to lower the cost of health care, and also improve access to the highest quality of care, the best research, the best practitioner across the state," Brodeur said in his testimony. "We are one of the eight states that don't have the policy around telehealth and telemedicine, and we need that."

Aside from providing clear explanations on "telehealth" and "telemedicine," the House bill defines what practitioners can do. The regulations include obtaining consent for treatment from the patient, and prescribing drugs that have the same standard of care as in-person settings and not a controlled substance.

"I think it's important to make sure that we create a safe environment to the folks practicing via electronic connections, [so they] can do some of the things that in-person visit can do," Brodeur said.

Telemedicine has been a highlight at the Statehouse, included in a package of health care legislation offered by the Massachusetts Senate in mid-October. The package was dubbed as the biggest health care reform bills to hit Beacon Hill in years, and includes guidelines in delivering and reimbursing telemedicine. It was scheduled for debate Thursday.

Ironically, people who are the targets in this long-distance health care service might not be able to enjoy the benefit.

"Telehealth is a terrific idea; I think it's game changing in terms of delivering better care, but without the infrastructure, we would leave the Berkshires behind," he said.

His bill explains that telemedicine doesn't include the use of audio-only telephone conversation, electronic mail, instant messaging, phone text or facsimile transmission. Rather, it involves exchanging high volume of health information, such as X-rays and magnetic resonance imaging results and video conferencing between patients and practitioners.

The system needs strong and stable internet connections, something that is not a problem for Brodeur's Middlesex County constituents. But in places where slow Wi-Fi connections are only available in public schools from 9 a.m. to 3 p.m. or no internet connections at all, telemedicine is still too far off.

Farley-Bouvier noted that access to physical and behavioral health is always hampered by poor communication and public transportation — two major challenges in the county.

"If we want equal access to any kind of services in this day and age, everybody needs access to broadband. We need to make continued investments in broadband," she said.


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