The use of telehealth has dropped since its peak during the height of the COVID-19 public health emergency, but more Coloradans continue to opt for remote visits, especially for mental health, according to a new report.

Telehealth services spiked by more than 900% in 2020 compared to pre-pandemic months.

Dianne Primavera, Colorado Lieutenant Governor, leads the state's Office of eHealth Innovation and said telehealth is key to achieving state goals for expanding access to health care.

"One of the silver linings of the pandemic was that it catapulted the use of telehealth, both locally and nationally, and showcased the opportunity that we have to increase access to quality health care in communities across our state," Primavera said.

Use of telehealth services dropped 11% from 2020 to 2021. The report showed, however, that Coloradans continue to access eHealth services at a significantly higher rate than before the pandemic.
The Center for Improving Value in Health Care's latest analysis includes data from January 2019 to January 2022, which captures telehealth use prior to and nearly 2 years after the onset of COVID.

Telehealth is a major part of a roadmap established by eHealth Innovation, and officials can tap data from the All Payer Claims Database to inform work on expanding access statewide by 2024. Primavera said making visits accessible to communities that face the biggest barriers to in-person services comes with layers of challenges.

"That's going to require a holistic approach that includes increased access to affordable high-speed internet, to web-enabled devices and access to training on how to use these tools," she said. "And this will hopefully get people connected to all the essential services."

Primavera added stigma continues to be one of the biggest barriers for addressing behavioral health. In smaller towns, where people may worry that their vehicle parked outside a mental health-care facility might be recognized, telehealth provides a confidential option.

"Weather can be a barrier." Primavera added. Not having access to a bus route or a bus ticket can be a barrier. Maybe you can't get child care and you have an appointment, so that can be a barrier. So it's really taken away many of the barriers to accessing mental-health services."

A Chicago mom who lost her son to cancer in 2022 is using the occasion of Mother's Day to call on Illinois lawmakers to pass medical aid-in-dying legislation.

Suzy Flack's 34-year-old son Andrew was a special-education teacher and avid hockey player living in California when he learned his cancer was terminal. Rather than return to his home state, he stayed in California, where medical aid-in-dying is legal.

Now, with such legislation under consideration by Illinois lawmakers, Suzy Flack is using social media to urge its passage.

"Like I said in the video, I didn't realize how horrific cancer was," she said. "So, I would really like to stress that that comfort level that he had because he had the control over his death."

The legislation would allow mentally capable, terminally ill adults with six months or less to live the option to request a prescription for medication they could use to end their life.

According to a 2023 survey by the group Compassion & Choices, more than 70% of Illinois residents support such a law, while 17% would oppose it.

With no legal way to end his life in his home state, Flack said her son was unwilling to leave California because he wanted a peaceful death.

"That option of having the medication was strong enough to keep him there, despite missing his family," she said, "and certainly, it would have been easier for all of us if he had been back in Illinois."

In addition to California, medical aid-in-dying is authorized in ten other states and Washington, D.C., while two additional states - Wisconsin and Massachusetts - are considering legalization. The Chicago-based American Medical Association has not endorsed the legislation.

It's National Nurses Week, and educators and healthcare officials say there just aren't enough of them to go around. A combination of retiring baby boomers and nurses who chose to leave the field after the pandemic has left a projected shortfall of more than 5,400 nurses in Nebraska's hospitals, clinics and long-term care facilities.

Linda Hardy, Nebraska Nurses Association president, explained that the system is not training enough new nurses to fill the vacancies.

"I think across the country we have a nursing shortage," she intoned. "But the other thing we have a shortage of are nurse educators - and also, clinical sites for student nurses to be able to practice their clinical skills."

According to a Nebraska Health Care Workforce Collaborative report, 66 of the state's 93 counties have been declared medically underserved, and nine have no nurses. The report points to degraded "emotional health and well-being" as the main reason for staff shortages.

Hardy added healthcare providers and state officials are studying how to increase the investment in educational facilities and clinical sites to train new healthcare workers, and said one goal is to recruit them when they are young.

"There's a collaborative effort to try and get more healthcare workers, not just nurses but radiology techs, pharmacists, etcetera, into the pipeline from high school kids. So, that's a good thing," she insisted.

Carole Johnson, administrator of the Health Resources and Services Administration, said her mission during National Nurses Week is to highlight the vital role nurses play on the front lines, providing care, comfort and support to patients every day, but added the best way to honor them is to support them from training through retirement.

"You have to be investing in the nursing workforce. And so we're providing scholarships, loan repayment, stipends, upskilling - a whole host of training initiatives to really help ensure that we can recruit people into nursing and that when they're there, that they stay," she continued.


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Birth doulas assist new moms with the stress, uncertainty and anxiety of childbirth, while another type of doula offers similar support to those who are dying.

Death doulas, or end-of-life specialists, give spiritual and emotional support to people nearing death in a nonmedical setting. The word 'doula' comes from the Greek word 'doule,' meaning 'female helper.'

Kim Burgess, end-of-life doula and board certified adult geriatric nurse practitioner for Comforting Transitions, an elder care facility in O'Fallon, said fulfilling a dying person's wish to be in their desired setting is important.

"When I was in the home, primarily geriatric population, people wanted to stay in their home; the comfort of their home, their own surrounding, their own food, their own loved ones," Burgess explained. "I loved to being able to support people in that role."

Training to become an end-of-life doula happens in workshops, with required reading and work-study assignments. Since it is not a federally recognized field, insurance companies do not cover the services. The Illinois Department of Public Health said in 2022, Cook County alone saw nearly 46,000 deaths. Almost 20,000 were between ages 65 and 84.

Death, or what is sometimes called "the other side," can produce feelings of fear, or a sense of denial, especially if a terminal condition has been diagnosed. Burgess observed it is a 24-hour job for loved ones helping someone in their final days or weeks. She has encountered families who are unprepared for the caregiving needs.

"A lot of times, their family is saying, 'We're just overwhelmed, and we have hospice involved, but we still feel like we need some more support,'" Burgess recounted. "An end-of-life doula can be there, giving the family reassurance or making some slight suggestions on how to comfort their loved one."

Doulas can also help plan an advance directive, instructions a person can leave behind about their funeral service or cremation, what to do with a pet or help writing a loving message to family and friends.