COLEBROOK, N.H. — Over the last couple decades Upper Connecticut Valley Hospital has embraced and expanded the use of a telehealth program to provide its patients with a variety of medical services in the rural region.

Since the late 1990’s, UCVH has employed telehealth services, beginning with tele-radiology for remote reading of UCVH’s x-rays, CT scans, etc. These are currently read remotely from Dartmouth Hitchcock’s [“D-H”] campus in Lebanon. Since the 1990’s, the telehealth services offered at UCVH have expanded dramatically in order to meet the growing healthcare demand in our region. Today, UCVH employs telehealth in the Emergency Department, Pharmacy Department, and the Medical/Surgical Unit (behavioral health) all through D-H as well as tele-hospitalist services through Catholic Medical Center in Manchester and outpatient tele-neurology through Androscoggin Valley Hospital. This fall UCVH plans to add tele-rheumatology through D-H.

While the telehealth experience may be new for some patients, it is rapidly becoming commonplace. In fact, legislation in NH and around the country has made it so that now a telehealth encounter with a physician meets the same legal requirement of an in-person exam. Reimbursement has progressed significantly, as insurers are seeing telehealth as a way to provide cost-effective access to patients.

“Given the remote area in which we live and the challenges our community members face with respect to transportation, it is imperative that UCVH finds creative ways to bring care to our patients rather than forcing our patients to travel to the care,” said UCVH President Scott Colby. Colby went on to say, “tele-health and the partnership we have developed with D-H and others, provides that access locally.”

Telehealth is truly a partnership between our organizations. For example, Dr. Kevin Curtis, Medical Director for Dartmouth Hitchcock’s Center for TeleHealth pointed out that in the case of the Emergency Department, “The tele-E.D. services supplement the care in UCVH’s E.D. and are not intended to replace local staff.” Dr. Curtis went on to say that the care delivered at UCVH by its Emergency Department “is quite impressive” underscoring that the D-H telehealth team plays a supportive role for the local care team.

Over the last year, UCVH has generated thousands of telehealth encounters including over 7,000 imaging studies, 7,500 prescriptions dispensed to patients in the hospital, 175 neurology visits, 50 behavioral health visits and 25 emergency visits – all done through telehealth. The rural nature of northern Coös County and UCVH’s use of telehealth led to a recent visit to Colebrook by the Peruvian Ministry of Health on April 25th.

The visit, coordinated by Dartmouth College’s Center for Global Health Initiative Program, showcased how Dartmouth College is working with other countries to offer telehealth solutions. With the vast geographic diversity of Peru, consisting of seacoast/urban, Andes Mountains and Amazon jungle, Peru faces significant challenges in deploying healthcare resources. Seeing how UCVH employs this technology and the similarities in barriers to accessing care (travel, inability to recruit providers and cost), the members of the Peruvian team were quite impressed with UCVH’s program. As Dr. Curtis said, “whether the barrier to accessing care is caused by a patient’s inability to travel four (4) hours or four (4) days, a barrier is a barrier and will prevent access to much needed care.” Anne Sosin, of Dartmouth College stated how impressed the Peruvian Delegation was with the program at UCVH and the applicability of what they saw here in Colebrook to their situation in Peru.

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