A new report by The Commonwealth Fund showcases several representative solutions implemented by organizations to meet the challenges of rural health care. While Americans living in these underserved areas have a higher poverty rate, a higher incidence of illness, a lower life expectancy than their urban counterparts, and less access to health insurance and physicians, the innovation of rural health care facilities suggests that with enough time and creativity, the difference between rural and urban health care and outcomes can be significantly reduced. Below are some of the problems and approaches described in the report.
1. Physician shortage
On average, rural areas have 39.8 physicians per 100,000 residents; urban areas have 53.5 physicians. To meet the need for health care providers and attract more physicians, Rusk County Memorial Hospital in Wisconsin hired three advanced practice nurses as on-call hospitalists. This eliminated the need for primary care physicians to check on hospitalized patients or take call. As a result, hospital patients were admitted and discharged more quickly, and they received medical care more quickly. New physicians have been recruited more easily, since they don’t have to live in the area to be on call. The hospital reports shorter stays, a higher quality of care, and much higher patient satisfaction.
2. Small population samples
A rural hospital may have less than 25 beds, leading to a small data sample. Accountable care organizations (ACOs) have formed so multiple facilities can aggregate patient data, combine information technology (IT) systems, evaluate performance, and redesign workflows to improve the quality of care they provide. The ACO funding has allowed some facilities, such as Blue Hill Memorial Hospital in Maine, to hire nurse care managers to assist high-need patients with their care transitions. Since both ACOs and rural health care depend highly on primary care, ACOs have worked well in these regions.
3. High-need patients lack support
As mentioned above, some health care organizations have hired specialists to work with high-need patients during care transitions. The Southeast Health Group in Colorado provides navigators to help patients in anything they need to succeed. For instance, these navigators drove patients to office visits, picked up prescriptions and healthy foods, and secured mental health treatment and housing. Along the way, the navigators get to know the patients and are able to coach them as needed.
4. Lack of transportation and broadband Internet connections
The report touched on these issues, citing the lack of transportation as a challenge to patients trying to follow up on office visits. The lack of broadband Internet connections suggests that telemedicine will not work in these regions; the Commonwealth Fund overlooked solutions such as swyMed’s DOT Telemedicine Backpack, which is designed to deliver mobile health care in low-bandwidth situations. And for home health care, the swyMed software platform functions in homes with low bandwidth connections so patients can follow up with providers from the comfort of their homes. As ACOs and other organizations recognize the need for telemedicine and in-home visits, swyMed will be on the leading edge of technologies that are ready to fill this need.
To read the report, click here.
To learn more about the DOT Telemedicine Backpack, click here.
To learn more about swyMed, click here.