Last week, the Federal Communications Commission announced two grants totaling more than $800,000 had been awarded to a Birmingham-based counseling service and a Troy hospital, which plans to expand telehealth services across 10 community health centers it serves. The grants follow an earlier round of funds aimed at buttressing telemedicine efforts as social distancing spread across the country this spring.
The coronavirus pandemic has led to unprecedented growth in the telemedicine and telehealth sectors, an avenue some health care practitioners may have been hesitant to pursue before it became vitally necessary. As doctors were forced to cancel non-essential visits and procedures, federal entities such as the Centers for Medicare & Medicaid Services began relaxing certain reimbursement and co-pay restrictions that allowed for broadened services.
But for one Montgomery organization, serving isolated and vulnerable Alabama patients is nothing new. Medical Advocacy and Outreach, or MAO, serves HIV-positive patients through 10 e-Health satellite offices scattered throughout central Alabama and its Wiregrass region.
"Right now, I can host 100 concurrent video calls, and that’s provider to patient. I’m working to change that to 200. That is all ours," said Billy Sample, MAO Telehealth Resource Center Program Manager. "That means we don’t have to depend on Zoom being up or any other provider out there that are just getting overwhelmed."
MAO hope their years of pioneering telemedicine in rural Alabama can serve as a blueprint for health care providers charting new territory in a post-pandemic society.
"This is terrible, people losing their lives or contracting a virus that is brutal. There’s nobody left untouched. It’s horrendous that this has occurred but it has put telehealth in the forefront. We have more organizations who may be seeing the fruits of the labor of people like our agency that have put in the groundwork to make this effective," Sample said.
MAO began with another pandemic: The HIV/AIDS crisis, which brought together a group of everyday volunteers in Montgomery in 1987, cobbling together everything from educational materials to transportation services to pastoral care for loved ones suffering in the area. What began out of volunteers home eventually grew to an office space, where social workers, nurses and doctors were eventually hired.
"This was a group of private citizens, and they were uniquely aware that the public had a need that was not being addressed," said MAO Thomas Stephens last year. "Our willingness to be pioneers, because we had no choice. It's passion."
The group spread south from Montgomery, treating patients out of a new Dothan hub by 1998. MAO now receives federal funding for HIV Initially funded by local benefactors, MAO's HIV services were eventually approved for federal funding, and it now offers HIV prevention, Hepatitis C care and holistic general primary care for its patients. Eight years ago, it launched its first e-Health clinic in Selma, offering everything from post-diagnosis mental health care to prevention to specialized care for pregnant people.
In years past, MAO would regularly load up a van with a nurse, a doctor and a social worker, making rounds to far-flung communities, eating up valuable clinical hours and funds. They invested early in new technology, which allows them to host teleconferences between satellite clinics and doctors on their own server, which they call the "bridge." Though they still see patients in-person, they're able to do more faster with the telemedicine technology.
As doctors around the country were forced to abandon their typical methods of care amid the coronavirus upheaval, MAO is now acting as a bridge to help them reach their patients in a new way.
"Not only are we seeing our patients, but we are leasing out bridge space so that other agencies can utilize our bridge and see their patients," Sample said. "Because of how simple it is to use, because it is hosted here, we have the ability to maintain the connection. ... We have the ability to help folks. Not only taking care of our patients, but helping others take care of their patients."
In their satellite clinics, licensed medical providers are always with a patient, whose information is transmitted over secure, HIPAA-certified connections. This spring, as the majority of their patients are immunocompromised, MAO limited the number of patients allowed in a clinic at any one time. The organization worked to set up secure video chats with patients across Alabama.
"I have expressed, and a lot of our providers have bought into the fact, that our moral obligation is to inject a little stability back into our patients lives, a little connection," Sample said. "Video takes a little more time to transition to, to get them to understand what to do, but to see their faces light up when they see the doctor they’ve been going to for so long makes it worth it. They feel that sense of reconnecting. It’s more work for us. It’s more work for me. But the moral obligation we have to try to restore a little bit of normalcy to our clients far outweighs anything else."
But video conferences require patients to have Internet access at their home, an issue in a state with a significant portion of its population living without adequate broadband coverage.
Estimates of how many Alabama households lack broadband Internet speeds capable of maintaining a video chat vary widely, but the coronavirus pandemic has thrown the issue in stark relief as millions of people are depending on home Internet service to provide education for their children, earn a living and access health care.
Gov. Kay Ivey in March announced $9.5 million in multiple grants across the state aimed at expanding broadband access. Senate President Pro Tem Del Marsh, R-Anniston, wants to allocate $800 million of $1.7 billion federal money for COVID-19 efforts to expand broadband across the state. U.S. Rep Terri Sewell is co-leading a congressional effort to dedicate considerable funds to broadband expansion in the next federal COVID-19 package.
"The coronavirus has only further highlighted the importance of high-speed, affordable Internet, as lack of access has made it more difficult for Alabamians to learn from home, access telehealth service and telework during the pandemic,” Rep. Terri Sewell said. “It is beyond time that high-speed Internet is treated as a basic utility and rolled out to every community across the country."
©2020 the Montgomery Advertiser (Montgomery, Ala.) Distributed by Tribune Content Agency, LLC.
