Telemedicine Strategies in Rural Hospitals for Emergency Departments and Intensive Care Units

Access Telehealth for Multi-specialties

Rural hospitals present many challenges, recruiting physicians, loss of income, and decreased utilization by the local community. Patients often must travel a hundred miles or more to access health care.  Telehealth provides local access and allows the hospital to retain patients assuring adequate financial resources.  During the past two decades, many smaller facilities have been forced into bankruptcy and/or closed.  Some have merged with larger hospital systems, however, the same challenge remains, obtaining and maintaining adequate physician coverage.

In some cases, physicians will provide coverage on a part-time basis with 'satellite' offices. However, this is not satisfactory since it removes them from their main office.  It also contributes to increased costs of maintaining a second office.

Telehealth can mitigate most of these costs.

The Future of Rural Health Care

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Challenges

Ensuring the local community and surrounding regions can rely on their local hospital for a range of specialty care: With limited availability of local specialists, the hospital needed timely access to acute care specialists.

Reducing outbound transfers: The hospital was seeking a solution for reducing the number of patients requiring a transfer to a higher level of care due to a lack of local specialty coverage.

Increasing the case mix index: An increase in the case mix index was a top priority for the hospital as it sought to position itself as a specialty care hub for the region.

Providing a sustainable workload for its outpatient physicians: Many physicians and nurses were covering patients at the hospital and nearby clinic, leading to high levels of burnout and an increased burden on on-site staff.

Attracting Primary Care Physicians is a major undertaking for rural hospitals.  Even more so for specialty physicians.

Population density in much of rural America is very low, many towns have less than 1000 people, barely enough to support one PCP, let alone specialists such as general surgeons, orthopedic surgeons or hospital-based radiologists, and pathologists.