How the Response to COVID-19 Could Positively Impact Rural Patients

​Proper care for rural patients in America poses a real challenge. Imagine suffering a brain injury and the nearest city of 100,000 residents or more is 3 hours away. I use this specific population because in the U.S., it almost always requires this size of city to fully represent the sufficient amount of healthcare disciplines required for complex illnesses, such as encephalitis, inflammation of the brain.
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The physical location of rural patients often impedes access to qualified professionals with knowledge in the brain disorder, encephalitis. However, as the healthcare world has quickly adapted to telehealth, this provides new opportunities for those in remote locations.
 
As complex patients, those with encephalitis typically require oversight from multiple healthcare disciplines. Based on the implications and extent of damage to the brain due to encephalitis, a patient may need access to neurology, psychiatry, neuropsychology, physical therapy, internal medicine, pulmonology, speech therapy, psychology, immunology and epidemiology. In smaller populations, there is limited or potentially no access to some of these specialists.
 
The likelihood of driving from a rural area to a larger city with all of these disciplines and seeing all the healthcare professionals needed for ongoing care is impossible without incurring the additional cost of staying in a hotel for several days, adding to the burden of those costs. Even if a patient makes the trip, it’s unlikely that they’ll see the most knowledgeable doctors who have a thorough understanding of encephalitis all within a 2- to 3-day span.
 
So how does COVID-19 produce any beneficial outcome when we consider the staggering number of infected people suffering and the alarming number of deaths? As the board president of Encephalitis411, a nonprofit that aims to improve the quality of life for those impacted by encephalitis, I see a silver lining for our rural followers, those patients and caregivers who access our hotline and ask for referrals in the absence of local help. 
 
While telehealth has grown in acceptance, this platform has catapulted since COVID-19’s surge while officials create more stringent means of social distancing. Telehealth is playing a critical role in day-to-day access to healthcare professionals. Patients in rural areas now have the same access as those who live within 5 miles of their doctors. This is a landmark turning point in supporting those who have been sorely underserved in the past.
 
My hope is that when COVID-19 is somewhat in the rearview mirror, however long that is from now, that we don’t return to “normalcy” in providing healthcare. I hope that telehealth becomes a common alternative, a platform to serve anyone, regardless of location.
 
Will insurers or payors need to change their policies? Yes! As an example, with my current insurer, I can only see providers in my home state. And one would  think living in a metro as huge as DFW that I’d have access to leading professionals regardless of healthcare discipline. Not true. Just prior to the “shelter in place” orders, I traveled on my own dime and paid my own 3-day visit (including hotel, meals, the appointment itself, and rental car expenses) to a therapist in Montana who specializes in vestibular disorders. This is where I challenge insurers to revisit their plans to provide access to the right specialist, regardless of location. They need to open their minds to treat our suffering and necessary treatments and not place barriers based on geography within the States.
 
In current discussions about the COVID-19 virus, for encephalitis survivors of infectious types, doctors in the UK don’t feel that these patients are at any higher risk that the rest of the population. They did say that auto-immune encephalitis survivors are at higher risk if they are currently undergoing treatment or have concluded treatment in the last 6 months. So if you have AE, please don’t go out unless you are going to a treatment. Please wear gloves and a mask to take necessary precautions. Otherwise, I encourage everyone to shelter in place and don’t take the risk. Ask for help. It’s ok.
 
I wish everyone safety and good health in this unprecedented time. Our first responders are putting their lives on the line. “First responder” has expanded beyond healthcare providers to grocery stores employees, mail and package delivery people, food delivery people, pharmacy staff, educators and those in the position of deciding the best care and precautions to stop the spread of this invisible enemy. Thank you for what you are doing to keep America going.
 
Becky Dennis is the author of Amazon’s top-rated book, Brain Wreck. She is also one of the founders and board president of Encephalitis411.org.