Many Alaskans have to travel a long way for certain healthcare treatments. But a bill in the state House aims to close that distance by expanding the list of providers Alaskans can see without having to leave home. KFSK’s Shelby Herbert reports.
Emily Nenon is the government relations director for the American Cancer Society. She’s been working to open up venues for telehealth for several years. Telehealth allows patients to meet with their healthcare providers online instead of in person.
“I love talking about telehealth, because there’s so much potential in our state,” said Nenon. “I would say we’re so uniquely situated to be able to take advantage of telehealth and, and really use it to deliver health care in an innovative way, and oftentimes in places and to people for whom healthcare wouldn’t be available, maybe at all. “
Nenon’s organization celebrated a temporary policy win during the pandemic, when the state government suspended a number of telehealth restrictions.
“So, pre-pandemic, in order to do a telehealth visit with a doctor in the state, a patient would have to do their first visit in person before they could continue to do visits by telehealth,” said Nenon. “For example, if they need to see a specialist that’s in Anchorage, they would have to fly and see that specialist in person. If you get further out than just a simple Fairbanks-Anchorage flight… you can imagine, right?”
Before the pandemic, an Alaskan patient couldn’t see a doctor out-of-state, unless that doctor and all the specialists on their care team were licensed to practice in Alaska. But the state’s emergency order lifted those rules, because people across the state were having a hard time traveling to access care.
Nenon says that was a game-changer for patients and their physicians across Alaska.
“There was a radiation oncologist in Anchorage that I talked to who during the pandemic had been able to do an initial education visit with a patient that was living in rural Alaska to decide whether they even wanted to go forward with that radiation therapy or not — and then get all the background in place so that when the patient did come into Anchorage, everything was already set up, they could get right to work, save that whole trip, save time,” Nenon said.
That grace period is over. The Alaska Legislature set many of those telehealth provisions aside when the state’s emergency order ended.
“So now, we have pre-pandemic, very limited access to telehealth,” Nenon said. “During the pandemic, [we had] lots of access to telehealth. All of a sudden, we go back to: you can’t access to your telehealth.”
But Senate Bill 91 seeks to bring some of those provisions back, for good.
The proposed legislation would let out-of-state healthcare providers on a care team provide remote services to a patient in Alaska.
It would also allow Alaskans to seek out a few more types of services through telehealth, if they aren’t “reasonably” available in the state. That includes things like behavioral health, substance abuse treatment, physical therapy, and audiology.
Phil Hofstetter is the CEO of Petersburg’s hospital. His first encounter with telemedicine was back in the late 90s and early aughts, when he was working in Nome as an audiologist — that’s a healthcare specialist who works with ears and hearing. He was one of only a few audiology providers for Nome and all the surrounding villages. And he says it was a struggle to keep up with the demand for care.
“There’d be a waiting list, sort of a mile long. I mean, sometimes, eight months long,” Hofstetter said. A” year later, I would go to the same community — I would see the same patient, they would have the same issue and they weren’t even seen. And I was at a point where I was like, ‘This is terrible. I can’t see patients this way.’”
Hofstetter says many of his patients were frustrated, and about to give up on seeking treatment. But then, he says, former U.S. Senator Ted Stevens won his hospital a substantial amount of funding for a telehealth project.
Keep in mind: this is all long before Zoom — or even broadband — existed. But Hofstetter says they created this system where he could complete in-person exams in remote villages, and then send the results off to a physician who could prescribe treatments.
“Everything was from the satellite, if you had internet,” Hofstetter said. “And everything was very, very, very slow. I was able to capture an image of the eardrum, and I could scan my results. It would like, in an email, get sent to a surgeon in Anchorage, and they would consult on it. And we would have a turnaround time of 24 hours. All of a sudden, overnight, I was like ‘Oh my gosh, this is going to change healthcare forever!’”
Despite his initial excitement, Hofstetter says telehealth isn’t the “no-brainer” he thought it was a few decades back. He has a few concerns about quality control and the potential for fraud.
“You don’t want to just [give them] the ability to overbill,” Hofstetter said. “The other thing that we’re concerned about is: you want to make sure that quality of care doesn’t get overlooked, which would really tank the telehealth model, if there’s people that are over billing because they can respond to something in five minutes, but it’s not an appropriate level of care.
A section of the proposed law does establish a list of grounds for disciplinary sanctions against out-of-state care team members who engage in fraud. Despite Hofstetter’s reservations — and whether the bill passes or not — telemedicine *is* part of his vision for Petersburg’s new hospital facility, which is currently in the works. One of the new buildings will have a section dedicated to telehealth services, where community members will be able to virtually check in with their providers who are based outside of Alaska.
The bill is sponsored by Sen. Matt Claman (D) and passed unanimously in the Alaska Senate March 22. It’s currently awaiting approval in the State House.
