Telehealth has become synonymous with healthcare during the pandemic. But as natural disasters proved time and time again this past year, many communities could have benefited from expanding their reliance on telehealth beyond video consults with doctors. 

On the morning of December 30, a raging wildfire ripped through several several small Colorado towns. “We had just 30 minute to pack up belongings pets, loved ones and stay alive,” said Lori Adams in an interview with the Daily Yonder. She is director of commercial and market development at Render Networks. “At least we have a home to go back to. Almost 1,000 homes were burned to the ground.”

In general, a natural disaster has at least three phases: 1. The often unpredictable initial impact when everyone is either hunkering down or running for dear life; 2. The immediate aftershock and assessment of damages to people and property; 3. The slow recovery path to normalcy. 

Telehealth is working into first responder protocol In the first phase. “In some places there are regulations that have been in place within the last two years that allow first responders to ‘treat in place’,” Colin Banas, M.D., told the Daily Yonder in an interview. 

He is Chief Medical Officer of telehealth and health IT vendor DrFirst. Communities are hiring staff to use telehealth to expand the reach of first responders in Phase 2, and telehealth can be the bulk of medical care delivered during Phase 3.         

“In our 500 square-mile service territory in rural Western Riverside, California we recorded in 2021 about 40 fire starts, including one where we actually lost a couple of miles of broadband and electricity infrastructure,” Kevin Short told the Daily Yonder. He is a General Manager at Anza Electric Cooperative, Inc. “We only have one little local clinic here, which we can feed with emergency power, and they recently added a backup broadband connection.”

Telehealth Success Depends on Quality of Broadband

“As technology improves and gains adoption, telehealth will make a greater impact on communities recovering from natural disasters,” said Dr. Milton Chen in an interview with the Daily Yonder. He is the CEO of telehealth vendor VSee. 

“Innovations such as continuously-monitoring medical devices and AI health coaches will keep more healthcare services easily accessible in the aftermath of a disaster and through infrastructure rebuilding.”

However, telehealth’s Achilles heel is broadband. Specifically, how quickly a community’s broadband network and electric power grid can recover from a disaster. That will determine how quickly telehealth can be put into play. Community infrastructure is often more reliable than that of giant telecoms and cable companies. 

For example, the North Georgia Network (NGN) is a broadband infrastructure network built by two area electric co-ops. NGN provides broadband and private connections for multiple overlapping 911 centers in their service. They also provide broadband connections to over 30 doctors’ offices in north Georgia, multiple hospitals, and private high-speed fiber connections to several major medical centers. This ensures reliable telehealth capabilities in the area.

Another example is the microgrid built by Anza, which is “an independently operating power network to meet local electricity needs in addition to the main electric grid,” Anza’s Kevin Short said. 

Anza can augment that microgrid with solar power and an expanding battery system, and can keep that entire operation up and running even with full telecommunications capability. “Until the local authorities show up we want to be as self-sustaining as possible in terms of power and communications,” Short added.

Grayson, Kentucky, has a population of 4,217. The tornadoes luckily passed them by, but their new broadband network hopefully will be finished by the time the next disaster has a chance to hit. They are using their federal American Rescue Plan Act (ARPA) funds to build a huge 100 gigabit per second symmetrical network that feeds every home. The town is partnered with Windstream, which is carrying a significant share of the network buildout cost. 

“The public’s access to telehealth in our community will be lightyears ahead,” Duane Suttles, a city clerk wiith the town of Grayson said in an interview with the Daily Yonder. 

“In the event of a natural disaster, once emergency power is established, access to 1 gigabit fiber by every building will enable emergency responders to greatly enhance medical treatments in the field and in homes when transportation may be delayed due to closed roads and bridges. Also, local healthcare providers can reach out and consult their peers in other locations.”

Putting Your Telehealth Ducks in Order

There are several ways to strengthen communities teleheath’s natural disaster readiness. In many parts of the country, cities are customizing RVs, vans, buses and ambulances with telemedicine tools, expanded medical capabilities, and wireless connectivity and hiring staff to bring healthcare directly to underserved populations in particular, as well as parts of the general public. 

For example, Flagstaff, Arizona,AZ has a mobile medical unit called the “Big Orange Bus.” Additional customizations can outfit some of these mobile units for critical care while waiting for first responders. 

Other recommendations include:

  • Using the expertise, power, and flexibility of Wireless ISPs (WISPs) and wireless technologies to quickly break down, move, and re-assemble hotspots. Telehealth backpacks can equip response teams with software, audio and video capabilities, 4G Internet access, digital stethoscopes, cameras and ultrasound, and battery packs. “We’ve got a few fire stations here, but they’re many miles apart, and the closest hospital is 45 minutes away,” saidsays Short. “It’s critical that we have telehealth available.”
  • Highways and roads could be abysmal after a disaster. Building out standalone high-powered Internet stations along rural routes to hospitals that emergency vehicles can connect to in case patients’ conditions deteriorate while en route, or facing delays could increase reliability, as well as designating schools, libraries and other buildings as “telehealth way-stations” for first responders vehicles and mobile medical units, and increasing Internet capacity. 

These stations should be opened during natural disasters to regular people needing telehealth, otherwise facing potential isolation from any medical help for days or weeks. 

  • A disaster can displace countless residents from their homes in an area. Losing multi-dwelling units (MDUs) such as public housing units or the Arkansas nursing home destroyed by a tornado adds to the misery. Before disaster strikes, plan to temporarily convert motels, college dorms, warehouses, and other facilities into ambulatory treatment facilities. Use these facilities for people needing chronic illness, natal, senior and mental health care.

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