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Telehealth services key to accessing and providing continuity of care during the COVID-19 pandemic

by Stephen Neal, Chief of Staff, Chinle Service Unit, IHS Navajo Area

Telehealth and telemedicine services have been a critical component of health care in the IHS Navajo Area during the COVID-19 pandemic response. The Navajo Area Indian Health Service improved the efficiency of health care, increased access to care, and screened and monitored COVID-19 patients in emergency departments and in homes using telemedicine. The Navajo Area helped reduce the spread of COVID-19 among frontline personnel and the public. Despite challenges and limitations with the limited broadband, poor bandwidth, and other issues, Navajo Area staff succeeded in connecting with patients to provide the necessary health care.

The IHS Chinle Comprehensive Health Care Facility is located in the central region of the Navajo Nation in northeastern Arizona. Unreliable and poor-quality broadband in the region presented challenges to providing telemedicine services to local communities. The Chinle Service Unit used telehealth to provide innovative types of telehealth services to our patients in the respiratory clinic and to screen patients coming in for evaluation of respiratory symptoms. Patient rooms were connected to a provider workstation using telemedicine to allow providers to screen patients for COVID-19 without having to physically enter the patient’s room. This helped minimize the risk of spreading COVID-19 and conserved supplies that were limited at the beginning of the pandemic.

In the Chinle emergency department, telemedicine was used to maintain visual contact, monitor, and communicate with COVID-19 patients, allowing for a high standard of care while continuing to minimize the risk of spreading the virus. Chinle staff also visited patients’ homes with tablet computers to facilitate telehealth home visits. Through these activities, Chinle Service Unit was able to maintain primary care relationships, protect patients and staff, preserve limited supplies, and discover new potentials in telehealth.

The IHS Northern Navajo Medical Center is located in Shiprock, New Mexico, which is in the northwestern part of the state on the Navajo Nation. The center used a variety of telehealth tools to provide health care during the pandemic to connect with patients. To meet the increased demands on the network, the IHS Navajo Area increased bandwidth and improved the facility’s IT infrastructure. They also worked to identify and use patient-friendly communication tools.

As we look forward, the IHS Navajo Area will continue to focus on upgrading the capacity to provide telemedicine services and information technology infrastructure. Telemedicine as a care delivery modality will continue to be an important part of our care delivery in the IHS Navajo Area.

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Stephen Neal, Chief of Staff, Chinle Service Unit, IHS Navajo Area

Stephen Neal, works as a physician assistant in family practice and is the chief of staff of the Chinle Comprehensive Healthcare Center. He recently completed his master's in clinical informatics from Oregon Health Science University and is a former National Health Service Corp scholar. Stephen has worked at IHS since 2016 and enjoys providing care and furthering technological advancement for IHS in Chinle, Arizona, in the middle of the Navajo Nation.