New Mexico is a vast state – the fifth largest in the U.S. But it has one of the smallest populations, ranking 36th with slightly more than 2.1 million people. In 2022, New Mexico also had the highest poverty rate in the nation at 17.6%. In 2024, it ranked 50th in education.
THE CHALLENGE
The challenges faced by the citizens of New Mexico in their everyday lives roll into complexities in their access to healthcare, said Dr. Mike Ruma, head of fetal medicine and maternal health at Perinatal Associates of New Mexico.
“Unfortunately, this storyline carries over to pregnancy as well,” he explained. “New Mexico has one of the highest teen birth rates and the highest maternal mortality rate in the country. Over a third of its counties are defined as maternity care deserts related to several labor and delivery unit closures in Las Vegas, Gallup and Artesia.
“Prior to daily use of tele-ultrasound, our maternal-fetal medicine practice reached out to rural communities with strategically located physician offices,” he continued. “These offices require a large footprint, numerous staff, and significant driving for physicians and other frontline healthcare providers.”
While painful and difficult, the COVID-19 pandemic opened Perinatal Associates’ eyes to the capabilities of telemedicine and tele-ultrasound.
“We opened two offices during this timeframe using these technologies recognizing the care we could provide to rural communities simply with a 10×10-foot room, internet connectivity, a sonographer and a Philips EPIQ Elite ultrasound system,” he reported.
“We also augmented our existing rural satellite offices using telemedicine and tele-ultrasound bringing all aspects of our perinatal practice to the patient in their community,” he added.
PROPOSAL
Perinatal Associates went with technology from vendor Philips called Collaboration Live, software available on a variety of the company’s ultrasound systems.
“Instead of requiring patients to drive from their rural homes to Albuquerque for detailed fetal anatomic ultrasounds and maternal-fetal medicine consultations, this tool enables immediate, real-time viewing of the ultrasound images and communication with the patient and our sonographer staff,” Ruma explained.
“In short, the technology would eliminate the need for the patient to drive to Albuquerque for perinatal care and our physicians would never need to drive to those rural communities, many of which are four hours away,” he added.
MEETING THE CHALLENGE
As the COVID-19 pandemic unfolded in the beginning of 2020, Perinatal Associates implemented Philips Collaboration Live on each of its 40 Philips EPIQ Elite ultrasound systems. All MFM physician staff began to conduct visits remotely from Albuquerque to any of the 13 clinic locations throughout the state.
“All our 35 sonographers use the collaboration tool to complete complicated fetal ultrasounds in real time with the MFM physician online interacting with the patient and informing them of the fetal diagnosis and subsequent plan of care,” Ruma noted. “The tele-ultrasound tool is unique, allowing for text chat and audio/video communication between the on-site sonographer and the reading ultrasound physician.
“Additionally, the on-site sonographer can give control of the ultrasound system to the physician, allowing access remotely to nearly all controls the clinician may use as if using the system in person,” he continued.
RESULTS
Perinatal Associates of New Mexico has been able to expand its rural outreach without stretching its staff too thin. It has provided critical access to perinatal care in numerous areas throughout the state that have lacked this care for years.
“We have been able to adopt technology to leverage our practice’s expansion without the need to hire additional staff immediately prior to patient volume being present to justify the expense,” Ruma reported. “Our practice has grown dramatically by implementing both telemedicine and tele-ultrasound, touching nearly 9,000 pregnancies of the more than 19,000 births in our state last year.
“We now have the power to help safely keep patients in their home communities for the entirety of their pregnancies, bringing them genetic counseling, diabetes management, maternal mental healthcare and perinatal care previously only available by driving hundreds of miles to Albuquerque, the major metropolitan city of New Mexico,” he continued.
The practice also has the power to identify patient issues not amenable or safe for delivery in the patient’s home community by identifying those issues through telemedicine and tele-ultrasound visits and then coordinating planned, safe deliveries in Albuquerque, where the state’s only tertiary hospitals are located.
ADVICE FOR OTHERS
“Healthcare was essentially forced to adopt telemedicine during the COVID-19 pandemic,” Ruma stated. “Many clinicians could not wait to get rid of telemedicine and abandon its unique capabilities. Others were worried about federal CMS and national payer reimbursement and the long-term maintenance of tele-capabilities in the U.S.
“My advice would be to continue to use telemedicine and advocate on its behalf so we can continue to provide unique care in communities that otherwise will go unserved,” he continued. “The power of telemedicine and tele-ultrasound cannot be understated. The acceptance and desire of patients to interact with healthcare professionals using this technology also is unabated.”
In 2020, Perinatal Associates of New Mexico completed 5,000 visits using telemedicine and tele-ultrasound. In 2024, it completed 20,000 telemedicine and tele-ultrasound visits. The numbers tell the story, Ruma concluded.
Follow Bill’s HIT coverage on LinkedIn: Bill Siwicki
Email him: bsiwicki@himss.org
Healthcare IT News is a HIMSS Media publication
WATCH NOW: Mount Sinai’s new CDIO offers an inside look at her very full plate