For smaller, rural hospitals, survival has become the name of the game—and not just for their patients. Keeping a physician on hand at all times in the Emergency Department (ED) is costly but necessary; unfortunately, this often results in rising salary costs and harried staff. However, hospitals participating in a hub-and-spoke rural telemedicine network are finding that rather than paying a physician to stay whether or not an emergency occurs, having instant access to physicians at a larger health system instead improves care management in the local ED and preserves limited resources—as well as boost staff morale and make it easier to attract new talent.
A recent study conducted by Marcia Ward, a professor of health management and policy in the University of Iowa’s College of Public Health, found that rural critical access hospitals—the spokes—view telemedicine as a way to augment limited resources, keep patients in the community, and reduce transfers. Larger health systems—the hubs—use rural telemedicine to extend their reach, develop new business, and reduce transfer and ED traffic that could challenge their own resources.
Ward’s study revealed that some hospitals welcomed rural telemedicine and replaced hours of physician coverage with advanced practice coverage—that is, physician assistant or nurse practitioner coverage with immediate access to a physician via telemedicine. These hospitals saved roughly $117,000 a year in salaries. In contrast, hospitals that continued keeping an ED physician on site 24 hours a day experienced a rise in salary costs by $138,000 a year. “The study finds that expanding options for provider coverage to include telemedicine in some rural emergency departments has noticeable benefits,” Ward explained. “This supports the viability of critical access hospitals at risk of closing and leaving their communities without local emergency care.”
Interestingly, the addition of telemedicine also helped improve staff satisfaction by lightening the load on physicians; with less ED duties, the physicians experienced a better work-life balance with less burnout, less staff departures, and more incentive for hiring new staff.
A similar study conducted two years ago examining the University of Mississippi Medical Center’s Tele-Emergency Care platform found that rural hospital admissions jumped by 20 percent; previously, those patients would have been transferred to UMMC for non-serious issues, depriving the local hospital of revenues and using UMMC’s resources unnecessarily.
Another study at UMMC looked at just one rural hospital: In just one quarter, the local hospital admitted an additional 101 patients. “It’s had a huge impact” on the dozens of rural hospitals throughout the state, said Tearsanee Davis, the lead nurse practitioner at UMMC’s Center for Telehealth.
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