Back to the Future – Telehealth

The more things change, the more they stay the same. During these COVID days, we took a look at past blogs and realized that they were remarkably prescient. There are many challenges to home modifications and aging in place that are still relevant today – in some cases over a decade later! In fact, one of the legacies of the pandemic is that Americans of all ages have a new appreciation for the importance and limitations of the houses, the structures, in which they live.

This summer our blog will explore these issues through Louis’s past blogs, talk about how they may or may not have evolved and the challenges we still face. This blog series titled “Back to the Future” starts today and will go through the summer with posts every other week. So stay tuned and tell us what you think!  


Our world has changed quickly in such a short amount of time due to technological and scientific advancements. The benefits that come with this phenomenon include 

  • Higher quality healthcare (vaccines and medicine, more research on diagnoses and treatments), 
  • Easier communication (email, text, various apps, and everything at the tip of our fingers), 
  • Increased safety (driving technology, wheelchair-accessible buses, better cell phone coverage)
  • Telehealth (turning the home into a healthcare site)
  • Improved delivery of services (Amazon, Uber, GrubHub). 

The other side of the coin is that with scientific and technology advancements come longevity, with longevity comes age-related mobility challenges, increased need for care, and greater propensity for injury, illness or disability. Are we utilizing technology to the best of our abilities in order to meet the increasing needs of the population? Are we doing that equitably?

Today we talk about telehealth, a relatively new advent in the healthcare realm and one that seems like a perfect fit to facilitate safe aging in place. Eleven years ago when Louis wrote this blog post, telehealth was being used in mostly rural areas, and even then it was scarcely used. Insurance coverage for telehealth services was just emerging (and via Skype, oh how some things have changed!) but was still not recognized for Medicare coverage below a few specific situations. Now, living through a pandemic, telehealth is almost the norm in some settings: mental health, primary care, initial specialty screenings and home health rehab, to name a few. In its public health emergency policies in 2020, the Centers for Medicaid and Medicare Services (CMS) embraced a broad range of telehealth services, which it had never covered before. It is very likely that those policies will continue after covid-19 is under control.

The Case for Telehealth by Louis Tenebaum on January 4, 2010

Telehealth is remote healthcare visits. The obvious use and value of telehealth is when the patient and healthcare professional cannot be in the same place. The clearest examples include a sailor on the high seas or the famous case of the physician in the arctic who diagnosed and treated her cancer for months before she could be evacuated.

The application most people think of is rural older folks. The distance and difficulty of rural travel make the value clear and obvious. The distance between patient homes makes house calls very expensive and the distance and difficulty for the patient and caregiver is avoided as well. The patient attaches a blood pressure cuff to their arm and their phone line or home health monitoring device (such as Grand Care Systems) while ‘visiting’ with a healthcare professional over a two-way video conference. This is pretty easy to envision now that Skype is a household word. There is obvious benefit for rural Aging in Place.

Though the distance is smaller, the trip is still difficult in non-rural areas. Try getting out of your apartment, down the elevator, ride the bus, find a cab or a ride and get across town for an appointment. How about the parking and traffic medical professionals face in scheduling home visits?

The case for non-rural telehealth may not be as obvious but it is just as strong.


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