There are no easy answers to the physician shortage crisis in rural America, yet telemedicine is proving a powerful tool to improve care on the patient and provider level. In the conclusion to our three part series on the state of rural healthcare in the U.S., we’ll dive deeper into the many ways technology can create more access for rural patients while also better supporting physicians and serving as a recruitment tool.
Increasing access for patients
The vast mileage separating people living in rural areas from healthcare services is a huge obstacle—especially for those needing specialty care. Telemedicine can be a more useful means to offer these services to patients instead of trying to staff specialists in remote areas. For example in Missouri, patients who would normally have to drive hours to see a specialist, such as a psychiatrist, can participate in Mercy Health’s “telepsych” program and receive exams remotely using video conferencing capabilities. Mercy’s telehealth capabilities also offers programs in other specialties ranging from stroke care to high-risk pregnancies.
Other specialities telehealth can provide rural communities include teleradiology, teleopthalmology, teledermatology, and teledentistry, among others.
In addition to telehealth’s reach, technology advancements in general can improve patient access to care and serve rural communities in many ways. An innovative collaboration between 14 northwest Kansas hospitals and their local EMS provider utilizes technology to expedite care for stroke and heart-attack patients in an effort to improve health outcomes in rural communities. “There’s a lot of miles out here in rural Kansas,” says Carol Groen, manager for clinical certifications and special projects at Hays Medical Center, one of the participating hospitals. “And there’s a lot of difficulty sometimes getting transportation.” Powered by technology, local paramedics can administer and interpret EKG or stress tests in the ambulance and relay data back to the hospital, enabling the facility to prepare the staff and equipment before the patient even arrives, affording patients timely care in critical situations.
Addressing the difficulty of recruiting providers in rural areas
An inability to recruit an adequate number of physicians to practice in rural America has hit these communities hard. As we reported last week, under the Affordable Care Act (ACA) funds were expanded and allocated to support special programs aimed at enticing physicians to practice in these Health Professional Shortage Areas (HPSAs). However, with the provisions that are in place under the ACA potentially disappearing with the new administration, additional solutions are gravely needed. In addition to providing the remote care of rural patients, telehealth can be instrumental in supporting rural physicians and recruiting more clinicians to practice in these communities.
Using telemedicine, doctors are able to consult and network with remote specialists at larger facilities, reducing the need to have specialty clinicians on staff, usually a big challenge for rural hospitals. For example in Alaska, an electronic intensive care unit (ICU) system enables rural providers to collaborate with intensive care unit staff based in Anchorage, who assist in monitoring and treating patients remotely.
According to Becker’s Health IT & CIO Review, in a report by the Institute of Medicine for the National Academies, Dr. Wilbur Hitt said, “Telemedicine fosters a collaboration that reduces the feelings of isolation that physicians may experience when they go to practice in a small town. With telemedicine, it’s like having one foot in the city but being able to live and practice out in a rural area. It’s also reassuring to know that you’re on the right track with the treatment plan and are staying current.”
Additionally, physicians might be more willing to practice in these rural pockets if they know they will have access to innovative digital technologies that will better support their efforts and benefit their patients who are facing unique and difficult circumstances due to limited access to quality healthcare. Accessible technology would be particularly beneficial in appealing to younger providers, many of whom have learned to practice medicine with many of these technological tools in place.
An investment worth making
Digital health does not hold all of the answers to rural America’s healthcare crisis—policy, socioeconomic and geographic factors all play into the region’s current health landscape. For example, basic infrastructure improvements are needed in many areas to create wider broadband access. Medicare reimbursement for telehealth expenses can also be a challenge by hindering telehealth’s expansion into rural areas.
Despite roadblocks, many rural providers feel telemedicine’s capabilities are what is going to help drive volume, improve care quality and save on staffing costs. As Dr. Stevan Whitt, chief medical officer at the University of Missouri Health Care told Modern Healthcare, “It is the thing that is going to allow small hospitals to continue providing quality care.” It would help them stay open—80 rural hospitals have closed their doors in the past six years. The research positioning digital health as a major asset to rural healthcare is powerful, growing and demands greater focus and exploration at the federal level to help address this crisis.