HHH: Library Telehealth Visits Revisited

Logo for Henry's Hightech Highlights

In May 2019, I highlighted the topic of telehealth for my Henry’s High-Tech Highlights blog series. I think it’s high time we take another look. Before this year, telehealth was a fairly new technology that only a handful of folks were thinking about and exploring. With the pandemic, it’s risen to the forefront of people’s minds, becoming more relevant than ever. Suddenly we need telehealth implemented everywhere, on a massive scale, as communities, especially rural ones, are facing a worsening health crisis. Many lack local healthcare facilities to visit and the necessary Internet connectivity to make virtual doctor visits work. Libraries around the country are poised to be the perfect partners in these efforts to bring this critical need to the community, and we just happen to have a pioneer right here in Texas leading the charge. 

Today’s highlight: Telehealth at the library


The Facts

First off, why do folks need telehealth access, especially now?

  • Rural hospitals have been closing at a catastrophic rate.
  • Many people in rural areas are located far from any hospitals.
  • There’s also a lack of transportation options (no public transit) for folks to physically travel to the hospital.
  • Even when transportation is available, patients are often reluctant to travel outside of their area.
  • And most significantly, there is insufficient broadband access, a requirement for telehealth, in many residents’ homes.

Additionally, many of retirement age buy homes in rural areas to live, but when they find they need more healthcare, they end up selling their homes and returning to the cities due to the lack of access. Adding telehealth services to libraries means these seniors could receive the healthcare they need, thus allowing them to stay, age in place, and have the quality of life they desire. Libraries have the opportunity to be transformative, helping to maintain the vitality of their communities.

Why are libraries the perfect telehealth partners?

  1. It’s a place already in communities to serve people’s needs that people trust.
  2. It has friendly, helpful staff who respect privacy and are pros at teaching digital literacy skills.
  3. It often has free high speed Internet, faster than many might get at home.

I think libraries and telehealth go great together, so I decided to make another promotional poster based on ones from World War 2 to support telehealth services at libraries.

Poster depicts librarian (dressed as Rosie the Riveter) holding an ethernet cord and standing proud in front of a waving American flag. The words "Telehealth Saves Lives" are next to her. Below, the text reads: "High Speeds Meet People's Needs. See your local public library. Telehealth Services at participating locations."
The previous poster I designed is placed next to the original 1940s one that shows a Rosie the Riveter type with her husband standing proud in front of the American flag. The text below reads "I'm Proud... my husband wants me to do my part. See your U.S. Employment Service"
The original poster on the left, and my remix on the right.

I’ve created other library tech posters in a similar style if you want to check them out.


A Pioneering Pilot

Despite the great match-up of libraries and telehealth, there are very few examples in the U.S. I’m pleased to report that Texas is leading the pack in this regard. Pottsboro Area Library, a very small rural library an hour and a half north of Dallas, has a new telehealth pilot project in partnership with University of North Texas Health Science Center (UNT-HSC).

Last week, I invited Dianne Connery, former Director (now Special Projects Librarian) at Pottsboro Area Library and Jessica Rangell from UNT-HSC, to present during a monthly Zoom “TechChat” for TLA’s Innovation and Technology Round Table (ITRT) to discuss the facts I’ve outlined above and give a brief update on the pilot.

Here is a youtube recording of the 30 minute chat from 2/25/2021 if you want to watch the whole thing, but I’ve also highlighted the key points below.

During her talk, Dianne described how patrons would come into the library during the early days of the pandemic, reporting that their doctors wanted to talk to them but didn’t want them coming in for appointments for fear of contracting Covid. Unfortunately, a virtual visit wasn’t possible for these patrons since they didn’t have Internet access at home. What were these patrons supposed to do? 

Dianne had recently installed fiber at her library in order to support an innovative eSports program, so she knew the library’s Internet was up to snuff for a video-conferencing call. At first, she ended up setting up telehealth visits for these patrons in her office so they could have their doctors’ appointments. This was just a stopgap solution, however. A clear need was being articulated by the community, and Dianne wanted to do more to address the issue.

Investigating further, Dianne discovered a grant available from the Network of the National Library of Medicine (NNLM) – South Central Region (SCR). She applied and was awarded funding to pay for lighting (more on that later), health collection development, hardware (webcam, microphone, computer), signage, and marketing materials so that she could set up an innovative telehealth pilot with her partners at UNT-HSC.

Photograph that shows desktop computer in a designated telehealth room with good lighting.
A closer look at Pottsboro’s telehealth setup. Note the lighting.

How It Works

Step 1: If someone in the community has the need for telehealth, they make a call directly to the Health Science Center to make the reservation. This protects their privacy (library staff never knows the names, only the times of the appointments). This is especially important in a small town where everyone may know each other. 

Step 2: Once the reservation is made, the patient can come into the library to a special designated room that is staffed by healthcare professionals. Besides the registration, the payment process and screening for Covid is all handled through the Health Science Center.

Promotional banner that reads "Check out telehealth at your local library!" and a bullet point list of : "Call to schedule your appointment, Complete your pre-visit check-in electronically, Show up at the library for your appointment" Below that is the contact info for UNT-HSC.
Promotional banner for Pottsboro Area Library and UNT-HSC’s telehealth program

Here are a few more points made by the presenters:

  • Offering this kind of telehealth service is scalable to any size library.
  • A library doesn’t need to have a separate dedicated room.
  • It does, however, require good Internet like from a fiber connection.
  • It also requires good lighting to ensure clinicians can diagnose their patrons with the same visual information they would have in person. 
  • As mentioned in my intro, many are now abuzz about telehealth due to the pandemic’s highlighting of the ever-widening digital divide. Legislators and funding providers are eager to support projects like this and bring telehealth to communities. So keep on the look-out; funding is coming!

A Community of Practice

With her pilot, Dianne says she’s building the plane as she’s flying it, just winging it really. This is such new terrain we’re all in. We will all benefit from the lessons learned from her attempt, but let’s get the conversation going and develop a community of practice.

Some questions to explore:

  • What kind of training do library staff need to set up and implement telehealth services?
  • How should libraries advertise this new service and reach people where they are? 
  • How should libraries implement good workflows to deal with infection control issues?
  • What are considerations not thought of?
  • What more can be done in this space? For example, could it be made mobile to visit patients where they are  – such as in nursing homes and assisted living facilities?

Are you considering telehealth at your library, or are you already doing it? Want to learn more? Please email me with subject line “Telehealth” if you have stories, ideas, or resources to share – or if you just want to stay in the loop with regard to library telehealth in Texas.

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