Complex pregnancy requiring an endocrinology specialist, how telemedicine helped expedite and keep care local

Case Study

Problem

It comes as no surprise that rural and smaller communities experience significant health disparities, due to multiple risk factors including limited access to specialty care such as endocrinology. When residents in these communities have complex conditions that require specialty care, patients are forced to wait months and travel outside of their medical homes to seek specialty care. This often results in delays, fragmented care, and higher costs for the patient and the healthcare system.
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Case Background

For many women, pregnancy is the first time healthcare is accessed routinely. This was the case for one young pregnant patient whose medical home is a hospital in a rural location. During her third trimester, she was diagnosed with thyroid cancer. Thyroid cancer is treated surgically, but in pregnant women, the complexities of medical decision-making are underscored by the need to weigh the potential benefits of any intervention for the mother against the risk to the fetus.

Case: Resource Limitation

Given the complexity of this situation, the patient’s primary care doctor recommended that she see an endocrinologist for further evaluation. However, there were several challenges to accessing care.
  • First, the patient’s local hospital did not have an onsite endocrinologist.
  • Second, the patient did not have the resources to travel long distances for care to an academic center.
  • Furthermore, the wait time for a consultation and surgery at an academic center would have been too long. Surgery already needed to be delayed to wait for delivery, so further delays would have been detrimental to the health of the mother.
  • Finally, after delivery, traveling long distances for appointments in the postpartum period would have been arduous given her lack of childcare.
In this case, Beam Healthcare was already providing multi tele-specialty services within the patient’s local hospital system, one of which was Tele-Endocrinology. A Beam Healthcare endocrinologist was consulted as a tele-specialist to see the pregnant patient with newly diagnosed thyroid cancer.

A Tele-Endocrinologist from Beam was able to see the patient immediately at their local Tele-Specialty Clinic. With the lead by the dedicated Tele-Endocrinologist, Beam was able to:
  • Keep the patient within the local healthcare system and close to home.
  • Provide expedited referral & discuss the clinical case with a well-regarded surgeon to develop a postpartum plan.
  • Coordinate care with the primary care provider.
  • Allow the patient to recover postpartum safely but still have the required surgery in a timely manner, all while being supported by her family members locally.

Summary

With Beam Tele-Endocrinology, facilities are now able to provide specialized care locally. Tele-specialty care reduces barriers to access and provides patients with a high level of quality care, ultimately allowing hospital systems to retain patients within their ecosystem.

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