Telemedicine: A boon to critical access hospitals

By: Keri Dostie | 9/21/17

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Telemedicine presents an opportunity for Americans living in rural communities to achieve access to important care while staying close to home. We hope to provide relevant information on this expanding application by defining telemedicine, how it can specifically help rural hospitals and the patients they serve, how to overcome barriers when implementing a telemedicine program and finally, presenting a case study of a successful rural telemedicine program.

As defined by the American Telemedicine Association, telemedicine is the delivery of care services and clinical information via telecommunications technology. Instead of meeting with a physician face-to-face, patients have the opportunity to receive a diagnosis, treatment information and other critical health care services remotely. This flexibility makes it easier for patients, such as those in rural communities, to receive quality care in a timely manner.

Currently, there are about 200 telemedicine networks and 3,500 service sites in the U.S., with over half of the hospitals in the nation using some form of telehealth. As technology continues to advance, more hospitals will likely follow the trend and implement telemedicine in some form.

In preparation for NRHA’s Rural Health Clinic and Critical Access Hospital (CAH) Conferences Sept. 26-29 in Kansas City, Mo., we've broken down telemedicine basics: How beneficial such technologies can be for critical access hospitals and how to overcome barriers that may be keeping CAHs and other small community clinics from making the investment.

How can telemedicine benefit rural hospitals?
Health IT, the backbone of telemedicine, has the ability to transform the world of rural health care as we know it. The Office of the National Coordinator for Health Information Technology states that, in general, health IT can improve the way providers collect, manage, store, use and share health information among health care professionals and patients. Additionally, it can better target health education, improve disease surveillance and increase care access to those in need, which in turn improves care quality and overall patient outcomes.

While telemedicine is substantially beneficial across the country, it's especially imperative for rural community clinics to consider investing in the technology. Here are a few ways telemedicine can benefit CAHs specifically:

• Gives physicians instant access to timely information to provide care appropriately.
• Decreases travel times to hospitals for both the patient and the family.
• Improves transfer from one facility to another for vital health care services.
• Utilizes remote physicians, pharmacists and other health care staff members to extend care access.

With telemedicine, rural communities can improve overall care quality and outcomes, as well as patient and family satisfaction which can advance the organization's overall reputation as a health care provider.

How to overcome barriers when implementing telemedicine
While telemedicine can benefit rural hospitals and small community clinics around the country, there are barriers keeping such organizations from implementing the system. Distance, isolation and constricted resources are the most common barriers that hinder rural organizations from providing the top quality care patients deserve. To overcome such obstructions and improve health care quality and patient outcomes, CAHs should consider the following to implement telemedicine successfully:

1. Encourage engagement
Before implementation, all physicians, executives and administrative staff members must understand the value of telemedicine and how it helps the organization achieve their goals. Rural CAHs must encourage engagement across the board to integrate and maintain health IT successfully.

2. Finance health IT
The cost of health IT adoption and implementation can be intimidating, making it one of the most common barriers keeping CAHs from investing in telemedicine. But in many cases, hospitals can complement some of their existing IT infrastructures to support their telemedicine initiatives. The cost of telemedicine technology has come down significantly in recent years. As the industry has moved towards software-based video conferencing, expensive hardware and equipment becomes less necessary. There are many government-funded grants for telemedicine as well as various finance options for leasing the equipment and technology. Both options are worth considering.

3. Invest in reliable connectivity
Providing physicians with access to reliable broadband connectivity is key to ensuring a telemedicine program is utilized to its fullest potential. Having a spotty or intermittent connection during a telemedicine consult will confuse patients, discourage users and devalue the clinical benefits of telemedicine for remote providers. It is important health care professionals feel confident in the care they can provide, with a reliable connection.

Success story: Carle Foundation Hospital
Carle Foundation Hospital is an integrated, not-for-profit regional health care provider that supports many CAH and regional hospitals throughout east-central Illinois, such as Carle Hoopeston Regional Health Center. Many of their patients and physicians dealt with the challenge of traveling up to two hours between Carle's regional health centers and their critical access hospitals. Additionally, transferring patients from regional hospitals for specialty care created a burden for individuals and their families due to traveling restraints and added health care costs. Lastly, regional facilities offer limited in-person office hours to see a specialist, leading to long wait times for appointments.

"Telemedicine is a way for us to move forward and improve the type of care they are providing to our community,” Harry Brockus, CEO at Carle Hoopeston Regional Health Center says. “The impact it has had to our community has been an improvement to access for our patients ... it is all about the patient."

By utilizing AMD Global Telemedicine's offerings and implementing the technology, Carle Foundation Hospital has been able to sustain success, improving patient care and access. Some of the achievements made by the organization since its telemedicine integration include:

• Delivered over 1,000 telemedicine at rural regional hospitals.
• Eliminated over 400 hours of travel time every year since implementation by offering remote consultations.
• Reduced patient wait times drastically.
• Decreased the need to transfer patients between the Urbana campus and other regional hospitals.
• Lowered the total cost of technology use by using web-based telemedicine software.

By making these improvements, Carle Foundation Hospital Carle and Hoopeston Regional Health Center can prepare for future growth and continue to improve care access to rural communities. By taking advantage of telemedicine solutions, other critical access hospitals in rural areas can do the same.

NRHA commissioned the above piece from AMD Global Telemedicine, a trusted NRHA partner, for publication within the Association’s Rural Health Voices blog.

AMD Global Telemedicine will exhibit at NRHA’s Critical Access Hospital Conference Sept. 27-29 in Kansas City, Mo.