Telemedicine comes to the American frontier

"Rather than duplicating the functionality of providers' established practice management systems, we created complementary features that help extend those systems into the mHealth space," he added. "For example, we help patients access their records online and, just as importantly, create personal health records by capturing notes during online consultation and journaling outside of consultation that can later be shared with providers."

For Thomas, a substance abuse and suicide prevention counselor for a number of Native American populations around the country, including the Volunteers of America's Circle of Hope program and inmates in Utah's correctional system, TruClinic offers him a vital link to the Goshute tribe.

"TruClinic has really opened up another door," said Thomas, who has traveled by train, plane and taxi in the past to visit remote tribes throughout North America – a difficult task, because he's blind. "I have always been of the mindset that I needed to be in the same space as the individual. (But) as technology has advanced and as I have also become more comfortable with technology, I have been able to adapt and become more comfortable with offering mHealth to tribal communities."

"With a lot of tribal communities I have consulted with over the years in the U.S. and Canada, I notice that there is a disparity with what type of healthcare is offered," he added. "In very remote regions in both countries, oftentimes with our tribes in the United States, the healthcare the tribes receive is from providers (who) for whatever reason are not the best quality of providers. I know there have been efforts over the years to improve the quality of care in clinics on tribal lands, and that’s where mHealth enables a more robust quality and accessibility of care being delivered to the Goshutes."

Chrissandra Murphy-Bullcreek is an alcohol and drug prevention coordinator for the Confederated Goshute Tribe. She's just starting to use the TruClinic platform. "It's an exciting service for our tribe," she said.

"We live in a remote area – 200 miles from the nearest big city, where most of our counselor/therapists live," she said. "They must travel or we must travel this distance to have the clients meet with the providers. It is really a hardship. An all-day travel and you never know what kind of weather you will run into."

"I would like to see healthcare services such as doctors (who) can diagnose the injury or health problem immediately," she said. "People that work with dialysis patients that can do their own dialysis, helping to make sure that things are done right. Many of our people leave the reservation to be closer to the dialysis centers, or they are transported three times a week over 150 miles one way to a dialysis center – a long day for a sick person.  Also people that work with the health insurance issues. Many times the papers aren't completed or followed up because it wasn't explained right/not understood."



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