The Nicest Place in Vermont: Cyberspace

"Telehealth for All"


A cancelled internship turns into a big opportunty for one student to help her whole state.

Lia Rubel is focused on one, simple mission: “We collect old smartphones and donate them to patients in need.”

But that wasn’t the case for the Emory University student just a few months ago. Like the rest of us, she was gearing up for the summer when COVID-19 crashed and plans changed.

“After receiving countless emails about canceled internships, I had just about concluded that I would be spending my summer twiddling my thumbs,” she says from her home in Barre, an historically blue-collar town of about 10,000 that grew from granite quarries that are now mostly dormant.

That’s when she got a call from a friend about a new initiative organized by some Yale University students who saw a great need across America become urgently greater in the era of coronavirus: People everywhere still need medical care but are unable or unwilling to leave their houses for fear of spreading disease. For seniors, who are more vulnerable to the disease and often need more medical care in general, it was a perfect storm. That’s why, in March, Telehealth Access for Seniors was born: to get communications technology, such as a smartphone or tablet computer, to elderly patients who lack and very much need it.

“It’s more than just a device. It’s a vital connectivity tool and it could save someone’s life,” says Rubel, 18, who joined the initiative in March as the lead for Vermont. “It just hurt my heart that they don’t have that privilege and they can’t connect to friends and families. They can’t even connect to their doctors.”

Born in the 1960s as part of NASA’s mission to put men on the moon (they might need medical care up there too), telehealth has experienced a renaissance in the era of high-speed connectivity and ubiquitous devices with screens. In 2002, a former NASA surgeon and engineer founded Teledoc, which became the first nationwide telehealth company in 2005; in 2015, the first medical facility totally dedicated to telehealth opened, Mercy Virtual in Chesterfield, Missouri.

lia rubel posing with an array of collected devicesCourtesy Lia Rubel
Lia Rubel, above, didn’t let her ruined summer plans keep her from doing something good.

But many people don’t have access to these services for lack of technology and connectivity, and the problem is worse in Vermont, where about 19 percent of the population is over 65 (versus 15 percent for the nation) and where 10 percent of residents don’t have access to broadband (compared with 6 percent in the United States, according to the FCC).

Telehealth Access for Seniors collects donations of electronics, usually unused smartphones and tablets, which they give to elderly, low-income or veteran patients. Since March, Telehealth Access for Seniors has expanded to over 50 volunteers in 26 states and they’ve raised an estimated $38,000 and donated 825 devices, Rubel says. In Vermont alone, Rubel has helped collect about 50 devices and $800.

“If they’re still self-quarantining, it’s really important for mental health,” says Rubel. “We include with the devices some suggestions to download wellness apps. And they [patients] use the devices to FaceTime family to stay connected.”

Just providing a way for an elderly person to have a “face-to-face” conversation with a loved one in an era of social distancing can be lifesaving. Feeling lonely leads to a 26 percent increase in mortality rate, according to a recent meta-study of 3.4 million people.

Telehealth Access for Seniors offers a free remote phone and email tech support team so that help is always available. The organization also provides instructions on how to set up devices and how to find and use free WiFi hotspots. “The pandemic has opened our eyes to how important it is to have digital tools and the importance of equipping our seniors with these devices,” says Rubel.

The Nomination

In mid-March, after a whirlwind week of impromptu good-byes, I finished the 18-hour road trip from Emory University in Atlanta, GA to my hometown of Barre, VT. After receiving countless emails about canceled internships, I had just about concluded that I would be spending my summer twiddling my thumbs. Luckily, I heard my phone buzz. It was Abe, a fellow delegate from the United States Senate Youth Program. He asked me if I would be interested in leading the efforts in Vermont for a new nonprofit called Telehealth Access for Seniors. I briefly scanned their website. In response to the COVID-19 outbreak, a group of Yale students had launched the nonprofit to enable elderly patients with telehealth-compatible devices. The home page stated, “We provide seniors and low-income communities with devices and instructions to connect them to their physicians via TeleHealth, friends and family using digital connectivity, and wellness tools via apps.” Immediately, I was intrigued. I texted back, “Yes.”

As I became more and more involved with the organization, I realized that the there was a much greater need for telehealth compatible devices than I had originally assumed. Given COVID-19, most medical practices have switched to a telehealth model where doctors connect with patients via video chat. Telehealth allows non-critical patients to receive care at home, reducing the risk of infection for everyone. Unfortunately, over 25 million older Americans across the country live in poverty and cannot afford the camera-enabled devices necessary to attend the telehealth appointments. Meanwhile, over half of older Americans have two or more chronic conditions, resulting in a higher risk of death and disability. Ultimately, the patients who can not afford the devices are often the same patients who are most vulnerable to COVID-19 infection. Seeing this problem, Telehealth Access for Seniors connects elderly patients with used devices so they don’t have to choose between receiving care for chronic conditions and staying home to avoid the risk of COVID-19 infection.

Ever since I joined Telehealth Access for Seniors, my mission as the Vermont Lead has been to collect monetary contributions and devices such as iPads, iPhones, and laptops to empower patients at the White River Junction VA Medical Center. The VA urgently needs 100 devices, and I will do everything that I can to reach that goal by the end of the summer. I use a variety of strategies to seek devices including posting on social media and Front Porch Forum, and reaching out to family, friends, Rotary clubs, businesses, and news outlets. It can be hard work, but the fulfillment is absolutely worth it.

Our combined volunteer efforts at Telehealth Access for Seniors have resulted in an impact of over 750 devices and $16,000 for over 50 partner clinics across the country. In Vermont alone, we have collected about 50 devices and $800. Earlier this month, I dropped off 24 devices to the White River Junction VA. I recently received a thoughtful thank-you note from the VA’s Volunteer Service Program Manager, Ms. Karen Campbell, and it reminded me of why I volunteer for Telehealth Access for Seniors. In this day and age, the devices we donate are more than electronic gadgets– they are essential tools that empower elderly, rural, and low-income patients to receive quality care. In the long-term, telehealth gives patients the ability to conduct regular check-ins at home, saving time, energy, and resources. Considering the substantial elderly and rural populations in this state, it is clear that telehealth is an integral component of a brighter and more equitable future for healthcare in Vermont.

I would be remiss to not mention the incredible support I have received from the Vermont community throughout this process. I am touched by the number of strangers who have given devices, cash donations, and kind words of encouragement. Many people have shared their personal stories of how telehealth has helped them and their older family members. One woman told me about her friend who suffers from brain cancer, and how telehealth revived her energy by reducing travel times. Thus far, seven Rotary clubs have given me the opportunity to speak about Telehealth Access for Seniors at their Zoom meetings. They have given generous donations and connected me to other audiences. I cannot thank them enough. Furthermore, I am grateful for the enthusiasm I have seen from Vermont teens and college students. After reaching out to UVM and various high schools about Telehealth Access for Seniors, I received numerous emails of interest from students. With eight college and high-school-aged Vermont volunteers as of this week, I am incredibly excited to work diligently this summer to fulfill the device demand of the White River Junction VA.

Despite the immeasurable loss that COVID-19 has caused, this pandemic gives us the opportunity to build a better healthcare system for everyone.