An investment in telehealth equipment for Horizon Health Care by SDN Communications, Alliance Communications, Golden West Telecommunications, West River Cooperative Telephone, Midstate Communications, and Interstate Telecommunications Cooperative, Inc., paid off during a 9-month provider absence in Bison. Thanks to TytoCare equipment available at the clinic, patients could still be seen for acute care ailments without taking hours out of their day to travel to a different town for healthcare.
In August 2022, a long-time provider transferred to another clinic. It was nine months before a new provider could start. The clinic had already been using telehealth, but it became more important once providers weren’t on site for more than a few days a month. In that time, 99 patients were seen via telehealth.
“Telemed was a Godsend,” said Angela Kolb, the clinic’s registered nurse. “Just to have the opportunity for people to be seen.”
Horizon Health Care uses a form of telemedicine in all three of its service areas – medical, dental and behavioral health. The TytoCare device used in the medical clinics can treat and diagnose respiratory, ENT, cardiac, dermatology, gastroenterology, and general conditions such as fevers. TytoCare is a handheld exam kit and app that lets staff in one clinic perform guided medical exams with a healthcare provider at another clinic. The exams are performed with a camera included in the device, an otoscope, stethoscope and tongue depressor adapters.
During the telehealth appointment, the hand-held TytoCare module is used to allow the provider to listen to a patient’s heart and lungs. An attachment is used for checking ears, nose, and throat. The provider controls the exam while directing the device to give a cue to what the nurse present with the patient needs to focus on next. The patient sits on an exam table just like a typical appointment.
Kolb said patients liked the process. They were impressed with how well providers hundreds of miles away could see inside their ears and throats.
“They were amazed the providers could listen to their heart and lungs and do so well with them,” she said. “The patients were very grateful to come in and do telemed. The little kids thought that was pretty neat too.”
The nearest clinic and hospital to Bison is Hettinger, North Dakota, a 45-minute drive away. It’s a busy place and sometimes patients have a hard time getting an appointment, Kolb said. It takes two to three hours out of a person’s day to drive there and back. With the TytoCare system, Kolb said, people could just stop in the clinic, be seen quickly and get back to work or school. It also worked well for behavioral health follow-ups.
“It’s just a big convenience to come down the street to the clinic to be taken care of,” she said.
The Bison clinic sees a wide variety of chronic care patients, Kolb said, such as diabetes and heart patients. Those are more difficult to see over telemed but some of that still takes place.
Having telehealth readily available prevented patients from putting off care and making the situation worse. It also kept them in town and with Horizon, Kolb said. The new provider, Mindy Dalley, can use telehealth to get a second opinion from another provider quickly. It’s also handy when a patient can’t get away from work on a day the provider is in Bison. Using telehealth gets the appointment out of the way quickly.
“Being so rural and as far away as other facilities are out here, it’s very important to have this available,” Kolb said. “I love this town and the patients. They’re all my friends and I want to take good care of them.”