Introducing Amnah Anwar

Danielle: 00:00:08

Welcome to a Virtual View.

Danielle: 00:00:09

Today I'm joined by Dr.

Danielle: 00:00:11

Amna Anwar, the new director of the Upper Midwest Telehealth Resource Center.

Danielle: 00:00:15

Thank you so much for joining us today.

Amnah: 00:00:16

Thank you so much for having.

Danielle: 00:00:20

could you tell us a little bit about.

. Amnah: 00:00:22

I've been with Indiana Rural Health Association for the past six years,

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starting the seventh year in September.

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And strangely enough, when I started with IRHA, I started with the Upper

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Midwest Telehealth Resource Center.

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At that time my role was program evaluation and a

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little bit of coordination.

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Eventually I stayed with U M P RRC for a year and then moved on other program.

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My work in the past five, six years has mostly focused on substance use disorder

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and mental health in rural Indiana.

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I've served in the program director capacity for Indiana

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Rural Opioid Consortium.

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That was a program that was funded through the Rural Health Opioid Program

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and the Rural Community's Opioid Program through its phase one and phase two

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which just ended on August 31st, 2022.

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Currently I also serve as the program director for the Community Paramedicine

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Program for Maternal and Child Health.

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And now I'm the program director for Upper Midwest Telehealth Resource Center.

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In addition to these programs, I also wear the hat of a senior director at

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Indiana Rural Health Association, where I supervise a team of six staff members.

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And I also lead the data team at IRHA in addition to my work at IRHA,

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I also work as a research associate for various different programs

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at the Polish Center at IUPUI.

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And I also teach the MHA program, some of the classes at Purdue University.

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Prior to my work with IRHA, I was a journal surgeon by training.

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I worked as a journal surgeon back in Pakistan.

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I've been in Indiana for the past 10 years.

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And that's, I have lived my past few years in my career as

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well as a professional life.

Danielle: 00:01:57

Welcome back to the UMTRC.

Danielle: 00:01:59

We're glad to have you.

Amnah: 00:02:01

Oh, thank you.

Amnah: 00:02:01

Glad to be back.

Danielle: 00:02:04

So with your medical background, what is your

Danielle: 00:02:07

experience with telehealth like?

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Is that something you've only engaged with recently or is that something

Danielle: 00:02:12

you have a longer history with?

Amnah: 00:02:14

My first introduction to telehealth was when I joined Upper

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Midwest Telehealth Resource Center back in 2016, and after I moved into the other

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programs with substance use disorder and mental health, I helped in planning

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and implementation of Telebehavioral Health programs in rural Indiana.

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I've also worked with recovery community organizations in the implementation

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of virtual peer recovery hubs.

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And then when Covid 19 hit, a lot of the work was involved in providing

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the necessary assistance and expertise when it came to convincing providers

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to deliver the medication assisted treatment through telehealth, the

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induction, as well as the other support.

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Behavioral health therapies, which are needed and deliver that via telehealth.

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So not as much as from the clinical side, but mostly from the, from helping clinic

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clinicians implement that program in their communities and in their practices.

Danielle: 00:03:12

Gotcha.

Danielle: 00:03:13

You touched on it briefly about how the pandemic really did affect the utilization

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of telehealth, but have you seen any changes in how the TRCs the telehealth

Danielle: 00:03:23

resource centers operate now versus pre.

Amnah: 00:03:28

Oh yeah, it's, the difference is day, night, and day.

Amnah: 00:03:31

Because when I start started back in 2016, and like I said, my

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role was as that of an evaluator.

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So I was really looking at the data about the technical assistance requests

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that were coming in to UMTRC and also representing the program at various

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different events and conferences.

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And if I recall correctly, most of the technical assistance questions that

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were directed towards the TRCs were based mostly on like the basics of

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telehealth how to implement telehealth.

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There were some questions about the technologies or the platforms that

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were available, HIPAA constraints, but mostly it was about reimbursement, like

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what was reimbursable and what was not reimbursable throughout the pandemic.

Amnah: 00:04:15

Like I mentioned, I worked mostly in the substance use disorder

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and the behavioral health realm.

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, I saw a huge shift, obviously when the world shut down overnight.

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Providers were finding ways and unique ideas in order to deliver the healthcare

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services that they could not do in person.

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And telehealth was already there.

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It was just a matter of implementing it in their practices.

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And even though I was not directly a part of a Midwest telehealth resource

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center at that time, I was yielding a lot of the questions that were

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coming my way on how to adapt the services, mental health services,

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Especially like the treatment and the medication for opioid use disorder,

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how to deliver those via telehealth.

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And at that time I realized that not only the providers were more open,

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but the patient patients who were receiving those services were also

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more open, probably because this was the only venue available to them to

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get the services that they needed.

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But at the same time, what I saw, The increased uptake and then the role of

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TRCs has changed from just providing the technical assistance when it comes

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to how do we start telehealth to now that we have telehealth, how do we

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cater it to our specific specialty?

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How do we do.

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The primary care visits via telehealth.

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How do we do the dermatology visits via telehealth?

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How do we actually assess the patient who is coming in for the induction of

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medication for opioid use disorder.

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We are telehealth, so all of those.

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All of that has changed.

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And in addition to this, I think the increased adoption was because of

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the waivers that were set in place due to the public health emergency.

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And now that I have taken over the stroll in the past 10, 12 days that

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I've been with the program, most of the questions are regarding the public

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health emergency and the waivers.

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If they're going away, which will, what will stay.

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Has a chances of being extended beyond a public health emergency.

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So there's a lot of that piece that is coming into when the telehealth

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resource centers are providing the technical assistance to not only the

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providers now, but also the consumers.

Danielle: 00:06:24

And I do think it's interesting that you point

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out that before that a lot of.

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questions that we had were more very general about what is telehealth?

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But now it's okay.

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Everybody knows about telehealth.

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How do we apply it to our specialty beyond just behavioral health?

Danielle: 00:06:39

We're doing all sorts of things in telehealth now.

Amnah: 00:06:42

yes.

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That is true.

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And then it also just shows that people have embraced telehealth,

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like it is a part of our, of every person's everyday life now.

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Because through these two years, at least once every one of us has utilized

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telehealth for, we use different purposes.

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It's not like it is an alien or it is something that only

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specific people would reach out to.

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utilize it's a part of our life and probably will continue to do

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so and expand as we move forward.

Danielle: 00:07:14

So what are your priorities as the new director of UMTRC?

Amnah: 00:07:18

I think every new director who comes in wants to take

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the program to the next level.

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That's what my priority is.

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I think the previous program directors delivered an excellent program at the

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time and which met the needs of the region that we are in, which includes Michigan,

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Illinois, Ohio and Indiana Obviously.

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But my priority when I come in at this point is also to expand upon the success

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that they had already re re achieved through the work that they had done.

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Like I mentioned, that UMTRC had created a lot of resources pertaining to the basic.

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Information about Telehealth in the past few years.

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But what we are going to do with our team is to expand those resources and

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make them cater them towards specific specialties and also specifically for the

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states that we serve, so that whoever is reaching out to us, we have those created.

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Products that we can actually direct them towards in terms of both the

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principal resources as well as if we can have recorded trainings

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and all of that is available.

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And obviously it'll also depend upon the technical assistance request that comes

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into TRCs to be better able to assess what is the need out there, what is the need of

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the time when the public health emergency ends, and how people can then, Modify

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their service delivery or modify their workflows at their practices depending

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upon the new reimbursement and the new rules, which will again, become effective

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after the public health emergency ends.

Danielle: 00:08:50

So why is it an important thing to have telehealth resource

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centers like the UMTRC freely available?

Amnah: 00:08:57

like I mentioned earlier, telehealth is here to stay and the

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technology is changing every day.

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There are new.

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Tools and gadgets available.

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There are new policy changes as policy makers are becoming more educated.

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NRCS have a role to play in that as well, providing that education.

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When it comes to policy makers, the things will change.

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Technology will innovate and people will adapt more to telehealth.

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Some of the providers who have not adapted it to the full extent, may

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move in that direction, and what Telehealth resource centers provide is.

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Expertise that the people who are looking into either expanding their

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practices or patients who are looking into trying to find a telehealth provider

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are the health systems who want to add on more services as a result of the

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telehealth resource centers are there.

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To provide that expertise in every aspect of telehealth healthcare delivery.

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It ranges from providing technical assistance to reimbursement, to policy

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updates, to information about the new gadgets of the tools that are available.

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So the need.

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For that, just like people turn to Google to find stuff or information that they

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don't know about TRCs or telehealth.

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Resource centers are like that when it comes to anything and

Amnah: 00:10:19

everything pertaining to telehealth.

Danielle: 00:10:21

Yeah, it's a lot easier to have one central resource you can go to

Danielle: 00:10:25

instead of having to Google a hundred different questions that probably will

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lead you to the same place in the end.

Amnah: 00:10:31

That is true.

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And then the telehealth resource centers also work as a part of the National

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Telehealth Resource Center consortium.

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So if there is something that our resource center does not have

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readily available, there are 12 other regional telehealth resource

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centers with experts having different.

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Areas of expertise, even within telehealth that we can reach out to immediately

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and can provide that information to the person who's seeking that are, or the

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healthcare entity who's seeking that.

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So not only is our staff at the upper Midwest Telehealth resource center at

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their fingertips, we're reaching out to TRCs, but they, by reaching out

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to even one trc, they have access to 12 other TRCs and the two national t.

Danielle: 00:11:13

Yeah, that collaboration is so important cuz it gets you not just

Danielle: 00:11:16

a couple of subject matter experts.

Danielle: 00:11:18

It gets you a whole country full of them.

Amnah: 00:11:20

That is correct.

Danielle: 00:11:21

Yeah.

Danielle: 00:11:22

So before we hop off for the day, I did wanna ask you what do you think the future

Danielle: 00:11:27

of telehealth in this country might look?

Amnah: 00:11:30

No one can predict the future.

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So if we, if somebody had asked two years back, what would be the

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telehealth adoption in the us we would not have guessed what it is right now.

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But if you look at our everyday life, just about everything that we do has

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been adapted to be done virtually.

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We do shopping online.

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We order food from our res, our favorite restaurants online.

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We play.

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Games and talk, and there are servers that people get on to talk and play

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with people all around the world.

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So we are living in a time where virtual connection is becoming even

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more readily available and people are adapting to that as compared to the

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in-person connection or Meetings when it comes to any aspect of our life,

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healthcare is just another aspect of our life where I think the virtual

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connection is just going to grow stronger.

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There is a whole new generation, which is comfortable sitting behind a camera

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and talking with other people even.

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Including their healthcare provider as compared to actually driving up and going

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up to their appointments, especially in the tele behavior health realm.

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So when we're talking about the future, I think it's only going to expand.

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It's going to expand and innovate because of the innovation and technology

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as well as the new enlightenment I guess, that the policy makers have

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had through the pandemic, that this is something which can actually save costs.

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Provide almost the same type of the healthcare services

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that are available in person.

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And obviously it is becoming more and more user friendly which also provides

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access to populations which would not otherwise have access to certain

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healthcare services, especially if you're talking about distant rural

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areas as well as the tribal areas.

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It is.

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I foresee it expanding.

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Now, how fast it moves post con post pandemic is a question that we'll just

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have to see, like how people will continue to do that when the waivers are removed.

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How are we going to modify some of the services that are being delivered?

Amnah: 00:13:36

But it's going to continue to.

Danielle: 00:13:39

I for one.

Danielle: 00:13:39

I'm very excited to see how it all sh shakes out and where we

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go with telehealth in the future.

Danielle: 00:13:44

So

Amnah: 00:13:44

am I.

Danielle: 00:13:46

Okay.

Danielle: 00:13:46

Thank you so much for joining us.

Danielle: 00:13:48

I'm glad that we could have this chat and we're really excited

Danielle: 00:13:51

to have you as part of the

Amnah: 00:13:53

Thank you so much for your time and this opportunity.