Many patients, however, were not.

For years, hospitals and health clinics in rural areas like Northeast Michigan had gradually introduced new ways to care for their patients from a distance using videoconferencing and other Web-based technology.

Then the virus closed buildings and forbade people from leaving their homes, and health care providers turned to that technology as a necessary way to care for their patients.

For some Northeast Michigan patients, though — especially the thousands who have little to no internet access in their homes — a virtual visit with a doctor is as difficult and nerve-wracking as a winter drive from the outer reaches of the region to the nearest hospital.

News Photo by Crystal Nelson Alcona Health Center Chief Medical Officer Thomas Marshall and Health Information Manager Carrie Porritt work recently at the center’s administrative offices in Alpena.

In Northeast Michigan, at least 6,700 homes lack the kind of internet connection necessary for modern life, according to advocacy group Connected Nation Michigan.

So health care providers have found themselves dispensing tech support as much as medical advice.

When, for example, the pandemic hit this spring and Alcona Health Center shifted to telemedicine, officials soon realized the internet service at many area homes was not up to speed, keeping doctors from connecting with some patients.

The center had to set up WiFi hotspots in their parking lots and walk computer tablets out to patients’ cars so people could meet with their physician.

“The advantage of the hotspot is the computer is already turned on, you’re already online with the provider, you could just hand it to them and talk,” Thomas Marshall, the center’s chief medical officer, said. “Very rarely did we have problems not being able to complete a visit once we went from the parking lot approach.”

Check out the video below. Viewing on mobile? Turn your device horizontally for the best viewing experience.

PROVIDERS AS TECH SUPPORT

It’s innovative thinking like that that will help medical care move forward in a technology-driven world, despite barriers presented by inadequate internet access, said Jillynn Oesterle, of the Michigan Center for Rural Health, which provides support and technical assistance at rural health clinics across the state.

Doctors serving patients in rural communities say telehealth services are here to stay and there are ways to continue providing those services — even expanding them — when the pandemic ends.

Despite technical difficulties, patient reluctance, and iffy internet access, virtual visits at local care providers skyrocketed.

In a five-year stretch, from 2015 through 2019, Alcona Health Center conducted just over 2,000 telehealth visits. In just six months this year, the center conducted 9,496 telehealth visits, more than half of all patient visits.

Still, in rural clinics statewide, staff report challenges helping patients understand how to use the devices and programs needed to connect virtually, Oesterle said.

With the virus’ unplanned and speedy shift to large-scale virtual health care, doctors, nurses, and other care providers were thrust into the role of tech support, not only learning on the fly how to use new technologies themselves, but also teaching patients how to log on to a video call or what to click to be able to hear their doctor’s voice.

“We had to find out an entire new way to do business on the fly, and we did it in about two weeks,” said Tom Wood, director of trauma and virtual care with MidMichigan Health, the Midland-based owner of the Alpena hospital.

Check out an interactive graphic below showing online health care stats. Story continues below graphic.

PATIENT BARRIERS

Sketchy internet service is an obstacle for many regions, a problem vastly greater for rural areas than in cities, Oesterle said.

But that’s not the only digital divide in health care.

Many patients — especially in areas with a large older population, such as Northeast Michigan — are unwilling to use technology to connect with their doctors, a study of older adults conducted this summer by the University of Michigan suggests.

Though most people are comfortable with the technology itself, three quarters of respondents were concerned because the physician couldn’t perform a physical exam during the appointment. Almost half said they worried because they didn’t feel a personal connection to a provider during a visit.

At 78, Ruth Rothe wants to see her doctor face to face.

“It’s just easier when you’re an old coot like me,” Rothe said cheerfully.

She and her husband, who is 81, have a variety of health issues and take care of each other at their home in the woods of Moltke Township.

She’s done a virtual visit, Rothe said — and it wasn’t too bad. With the help of her son, she could see and hear her rheumatologist. Though she’s no computer person, talking to her doctor on a screen was something she could get used to — if she needed to.

“I talked to him, and he talked back to me,” Rothe said. “It seemed to work good.”

Still, she wasn’t raised with computers, so, for her and others of her generation, using technology is not a natural way to communicate, Rothe said.

“Would I rather be home and do it on the computer? No. I guess the answer to that is no,” Rothe said. “I just kinda like that face-to-face thing a little better.”

Check out the video below. Viewing on mobile? Turn your device horizontally for the best viewing experience.

——

Virtual visits skyrocket

The number of virtual doctor-patient visits each year.

MidMichigan Medical Center-Alpena

Hospital Outpatient

2019 7,092 2,105

2020 6,428 6558

Alcona Health Center

2015-2019: 2,190

March-September 2020: 9,496

Sources: Mid-Michigan Medical Center-Alpena, Alcona Health Center

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