by Lisa Richard

There is a brand new law in the United States. The Expanding Capacity for Health Outcomes (ECHO Act) will bolster the use of telehealth for rural care. It came into affect at the end of 2016.

ECHO Act requires the Department of Health and Human Services (HHS) to work on ways to serve patients in hard to reach areas using the latest technology. Medical professionals will get specialized training so they can help patients through video conferencing and other methods that don’t require an office visit.

As Rural Outreach Specialist for the Center for Family Involvement I have personal and professional interest the Echo Act. I am a parent to seven children. Two of them have intellectual disabilities. I am excited to know that more is being done to understand the benefits of providing health care through telemedicine. As I explained in an earlier blog (, my daughter Zoe utilized telemedicine through a virtual visit with her psychologist over a television screen. The experience was strange but incredibly easier than the alternative of traveling almost an hour and waiting months for an appointment.

How will the ECHO Act influence the progress of telehealth and possibly help those of us who live in places where there is no Panera Bread? Here are some excerpts to better explain the changes:

IN GENERAL: The Secretary shall examine technology-enabled collaborative learning and capacity building models and their impact on:

  • addressing mental and substance use disorders, chronic diseases and conditions, prenatal and maternal health, pediatric care, pain management, and palliative care;
  • addressing health care workforce issues, such as specialty care shortages and primary care workforce recruitment, retention, and support for lifelong learning;
  • the implementation of public health programs, including those related to disease prevention, infectious disease outbreaks, and public health surveillance;
  • the delivery of health care services in rural areas, frontier areas, health professional shortage areas, and medically underserved areas, and to medically underserved populations and Native Americans; and
  • addressing other issues the Secretary determines appropriate.

The ECHO Act is a refreshing change for those of us living in rural areas. As we know, we are the forgotten ones in so many ways. Our difficulties are misunderstood, unknown, or swept under a rug. A recent op-ed piece by the Roanoke Times summed up our unique struggle quite nicely:

Virginia is often portrayed as a glowing example of the new economy, a high-tech center of international stature. All that’s true — as long as you’re talking about certain parts of Virginia. However, there’s also a part of Virginia where the old economy is dying, a place where people stand in lines at the county fairgrounds each summer to get health care in mobile units designed for Third World conditions — because that’s the only way they’re ever going to see a doctor.

Will the ECHO Act help? Can we in rural areas of Virginia who are taking care of children with special needs hope that this is the start of a new system of health care delivery that will help give us access to specialists in our hometowns? Only time will tell.

Just move. I have heard that many times from people as I have explained the difficulties of living in a rural area and taking care of children with special needs. If only it were that easy. All of us have many reasons we don’t or can’t move. I am hoping telehealth becomes more the norm than the exception. I hope that driving 5 hours to see a specialist becomes one of those things so foreign you have to explain it to your children – like wall phones with cords. Frequent visits to a doctor’s office become something you talk about when describing the “good ole days.”

I recently spoke with Dr. Karen Shelton, the Health Director of Mount Rogers Health District here in Southwest Virginia. She said telehealth is a wonderful tool for rural communities. She told me it will “provide needed medical care to those who cannot easily travel to centers of healthcare excellence. While primary care providers are still in short supply, specialists are generally not located in areas with low population density and long travel distances. Telehealth can bridge the gap so that people in rural communities can still receive the best medical care without the cost in time, transportation, lodging, and meals associated with travel to a specialist.  Public health is focused on improving the health and well-being of our communities and there is great potential for telehealth services in Southwest Virginia to help us achieve the goal of becoming the healthiest state in the nation.”

How wonderful would that be?!

SarahDugger-90px**About the author: Lisa Richard is the Rural Outreach Specialist for the Center for Family Involvement. She is the mother of 7 children and lives in Southwest Virginia.



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