Telehealth for chronic conditions in American Indian and Alaska Native communities
Follow these guidelines to help manage chronic conditions through telehealth.
Chronic conditions like heart disease, malignant neoplasm and diabetes are more likely to occur in American Indian and Alaska Native populations than other ethnic groups in the United States.
However, a lack of resources (staffing, funding), social determinants among American Indian and Alaska Native populations and a lack of specialty care services throughout these communities often leads to worse health outcomes.
Telehealth can improve quality of patient care for chronic conditions and strengthen the relationship you have with your patients.
Did you know?
In 2018, the Indian Health Service and the Centers for Disease Control and Prevention reported a 54% decrease in kidney failure among American Indian and Alaska Native people with diabetes. This reduction was produced in part by focusing on integrating better care for kidney disease within the context of routine diabetes care.
How to manage chronic conditions with telehealth
There are several ways you can use telehealth to help manage your patients’ chronic conditions. But there are some instances where patients will need in-person appointments. Examples include:
- Examination of surgical incisions or permanent ports
- Certain diagnostic or imaging tests, such as biopsies or cardiac imaging
- Suspected infection
- Acute illness or the inability to control the chronic condition through telehealth
According to the literature “Patient and provider perspectives on using telemedicine for chronic disease management among Native Hawaiian and Alaska Native people” (2013), “social distances” between patients and providers was one of the greatest barriers to effectively treating chronic conditions via telehealth in American Indian and Alaska Native communities. In this context, “social distances” means differences in cultures, languages and ways of conceptualizing concepts of health and wellness.
Consider taking a cultural competency training or speaking with community leaders to help reduce social distance.
While video telehealth appointments are the most common form of telehealth, many American Indians and Alaska Natives do not have access to reliable broadband internet.
Communicating asynchronously with a patient makes telehealth care for chronic conditions more affordable and accessible. It also saves time and resources for your practice with fewer phone calls, less paper filing, and fewer appointments to schedule.
Examples of asynchronous telehealth care for chronic conditions include:
- If your practice supports text messaging, it can help keep you connected with chronically ill patients who do not have access to broadband internet
- Sending X-ray images or lab results through a secure messaging portal
- Patients uploading their food logs if on a specific dietary plan
- Smartphone apps that track pre-exposure prophylaxis (PrEP) intake for patients at risk for HIV
Remote patient monitoring
Managing chronic conditions requires frequent testing and monitoring to keep the patient stable and healthy.
Remote patient monitoring options for chronically ill patients include:
- Blood sugar levels for diabetes management
- Blood pressure for cardiac patients
- Pulse oximeter readings for patients with respiratory illnesses
- Weight scales for patients being treated for obesity
This data, and any notes the care manager may have, are also uploaded into the patients’ electronic health record for other medical providers to review. If warning signs are present, alert the patient and order testing or change medications as necessary.
- Best Practice Guide: Telehealth for Chronic Conditions - from Health Resources and Services Administration (HRSA)
- Telehealth in Rural Communities — from Centers for Disease Control and Prevention (CDC)
- Telenutrition for the Prevention and Management of Diabetes (PDF) — from Indian Health Service (IHS)