El uso de la telesalud ha disminuido desde su punto más álgido durante la emergencia de salud pública por COVID-19, pero un nuevo informe señala que cada vez hay más habitantes de Colorado que siguen optando por las visitas a distancia, especialmente para la salud mental.

Los servicios de telesalud aumentaron más de un 900% en 2020 en comparación con los meses anteriores a la pandemia.

La vicegobernadora Dianne Primavera dirige la Oficina de Innovación en eSalud del estado. Ella afirma que la telesalud es clave para alcanzar los objetivos estatales de ampliar el acceso a la atención sanitaria.

"Uno de los aspectos positivos de la pandemia fue que impulso el uso de la telesalud," dice Primavera, "tanto a escala local como nacional, y puso de manifiesto la oportunidad que tenemos de aumentar el acceso a una asistencia sanitaria de calidad en las comunidades de todo nuestro estado."

El uso de los servicios de telesalud disminuyó ligeramente, un 11%, de 2020 a 2021. Pero el informe muestra que los habitantes de Colorado siguen accediendo a los servicios a un ritmo significativamente mayor que antes de la pandemia.

El último análisis del Center for Improving Value in Health Care incluye datos de enero de 2019 a enero de 2022, que capturan el uso de telesalud antes y casi dos años después del inicio de COVID.

La telesalud es una parte importante de la estrategia establecida por eHealth Innovation, y los funcionarios pueden aprovechar los datos de la All Payer Claims Database para informar sobre el trabajo de ampliación del acceso a todos los rincones del estado para 2024.

Primavera dice que hacer accesibles las visitas a las comunidades que se enfrentan a las mayores barreras para los servicios en persona conlleva varios retos.

"Eso va a requerir un planteamiento holístico que incluya un mayor acceso a Internet de alta velocidad asequible, a dispositivos habilitados para la web y acceso a formación sobre cómo utilizar estas herramientas," opina Primavera. "Y así se espera que la gente se conecte a todos los servicios esenciales."

Primavera afirma que el estigma sigue siendo uno de los mayores obstáculos para abordar la salud mental. En las ciudades más pequeñas, donde a la gente le preocupa que su vehículo estacionado afuera de un centro de salud mental pueda ser reconocido, la telesalud ofrece una opción confidencial.

"El tiempo puede ser un obstáculo, asegura Primavera. "No tener acceso a una ruta o a un boleto de autobús puede ser un obstáculo. Tal vez no puedas conseguir una guardería y tienes una cita, eso también puede ser un obstáculo. Así que se han eliminado muchas de las barreras para acceder a los servicios de salud mental."




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New Mexico saw record enrollment numbers for the Affordable Care Act this year and is now setting its sights on lowering out-of-pocket costs - those not reimbursed by insurance. More than 56,000 New Mexicans are enrolled in a medical health insurance plan on the state exchange - an increase of 12,000 people overall.

Colin Baillio, deputy superintendent with the state's Office of Insurance, said the state has boosted its outreach and made efforts to improve the overall consumer experience.

"We saw a 40% year-over-year increase, and New Mexico saw the biggest percentage increase during the open-enrollment period among all of the state-based marketplaces," he explained

Part of the enrollment increase is due to what's called the "unwinding" - a federal directive that required all states to redetermine Medicaid eligibility following a three-year pause on checks during the COVID pandemic. He said by using expanded tools made available by the federal and state government, 8% of New Mexico's population is now uninsured - down from 23% in 2010.

Following approval by lawmakers in the 2024 legislative session, the New Mexico governor signed seven health care-related bills into law - one of which requires annual reporting of prescription drug pricing. Baililo said the Affordable Care Act built the foundation that has allowed the state to pursue additional affordability initiatives.

"I'm really glad to see that there's so much interest in the next step of health reform, really leaning into these out-of-pocket cost issues and making it easier for people to afford to stay covered and see their doctors," he continued.

Two years ago, the state also passed a one-of-a-kind law that did away with behavioral health co-pays for people in certain insurance plans.

New York's medical aid-in-dying bill is gaining further support. The Medical Society of the State of New York is supporting the bill. New York's bill allows terminally ill people with only six months to live to use this option, with safeguards requiring two physicians' approval.

The bill's Assembly sponsor Amy Paulin, D-Westchester, said despite the growing support, other hurdles lie ahead.

"Now we have what I believe, if it came to the floor, a majority. There's still a hesitation on the part of leadership. You know, we need members to assure leadership that they no longer have reservations," she said.

Other newly resolved concerns center on making sure insurance companies and doctors who don't support this aren't held liable. She's optimistic the bill will pass after nine years in the Legislature. New York would be the 11th state along with Washington, D.C. to have medical aid in dying legislation.

Corinne Carey, senior New York campaign director with Compassion and Choices finds the pandemic drew a vivid picture of a person's end-of-life experience. There were images of people dying on ventilators, apart from loved ones, and unable to communicate. She said people began thinking about a "good death."

"And, what is a good death is being surrounded by loved ones, having some measure of control, experiencing the touch of your loved ones, and being the one in the driver's seat," she explained.

Now people have different options for end-of-life care, each of which presents various challenges. Polls show medical aid in dying has garnered considerable support since being introduced in 2015. A 2022 Compassion and Choices poll finds 57% of nurses support medical aid in dying professionally, although fewer support it personally.

The California State Assembly is considering a bill to require schools to have a cardiac arrest response plan. Assembly Bill 2887 would make sure schools update their safety plans to include CPR training and an automatic external defibrillator or AED onsite.

Dr. Stephen Sanko, a professor of clinical emergency medicine at USC, and a founding member of the Cardiac Arrest Survivor Alliance, is a volunteer expert for the American Heart Association. He said having a plan in place is critical.

"The American Heart Association is promoting that schools have a cardiac arrest response plan. A written protocol for what to do in order to decrease the likelihood that if somebody collapses, that they die," he said.

Two years ago, 15-year-old Cash Hennessy collapsed on the football field due to a previously unknown heart defect. Two off-duty medics in the stands gave him CPR. The school brought out its AED - but it was useless, because the batteries were dead.

Hennessy said the experience was traumatic.

"I feel blessed that I had people there for me, that could give me C-P-R. But I think about if those people weren't there and that was another kid, who knows what would have happened? Because there wouldn't have been an AED to save them," he explained.

An AED walks people through the steps to deliver a life-saving shock to a person's heart until an ambulance arrives. Studies show that 70% of kids who suffer sudden cardiac arrest at school recover if an AED is deployed correctly - whereas the survival rate for kids and adults not in the hospital is less than 12%.