Sadly, not all hospitals are equal, and not all regions come with the same problems and solutions. Rural patients and rural hospitals have always had challenges, but the data says that lately, they’ve been suffering more than ever before.
How can we help rural areas improve the quality, quantity, and accessibility of their healthcare? What can training, medical computer systems, and incentive programs do to aid the health and long life of folks who don’t live in cities or suburbs?
It’s a Numbers Game
Did you know that 45% of the total world population lives in rural areas? In the United States, that number drops to 20%, but that’s still a sizeable chunk of the populace. Around 65 million people, to be more precise. To give that number some perspective, that equals the entire population of the United Kingdom.
However, the number of doctors available in rural areas doesn’t quite add up: less than 10% of the nation’s doctors practice in rural areas. For those doing the math at home, that’s right — rural areas in the US have less than half of the doctors required to match the population.
And, to make matters worse, since 2010, 95 rural hospitals have closed, despite the general increase in population across the entire nation. The number of closures is only speeding up, too — between 2013 and 2017, twice the number of hospitals closed when compared to 2007-2012. That means the situation is rapidly deteriorating.
What’s Causing the Rural Healthcare Crisis?
Unfortunately, there are a few factors at play that are contributing to the deterioration of rural healthcare options. However, it’s best to understand them objectively so we can learn how to combat them.
Unsurprisingly, the recession hit rural hospitals hard. And, to compound the issue, recovery since then has been slow or non-existent. Rural jobs in industries like farming, manufacturing, coal, and timber have been disappearing as the United States moves further into a high-tech and service-based economy.
With the younger population moving toward cities, and income in the area decreasing, it’s no wonder hospitals and patients no longer have the resources needed for modern healthcare.
Federal Funding Troubles
56% of rural hospital revenue comes from Medicaid and Medicare, so when Medicaid or Medicare funding becomes the newest political dog bone, rural hospitals tend to suffer.
In fact, 80% of the hospital closures in rural locations corresponded with areas where Medicaid funding wasn’t expanded under the ACA.
Region-Specific Health Issues
Rural regions have always struggled with the mental and physical health issues that tend to become exacerbated in isolated communities.
A report from the CDC shows that suicide deaths had “the highest rates and greatest rate increase in rural counties.” Much of this is due to a lack of mental health care access. Obesity rates for men, women, and children were also around 10% higher in rural areas, which creates a greater strain on rural hospitals as well.
And, according to a study published by the Injury Prevention Research Center in Iowa, “rural populations have been shown to have disproportionately high injury mortality rates,” with 100% higher rates of workplace injuries, drowning, firearm wounds, car crashes, fires, and electrocutions.
The Drug Crisis
While the entire country has been struck by an opioid epidemic, rural areas seem to be losing ground even faster. A recent Morbidity and Mortality Weekly Report from the CDC shows that around 2015, rural areas eclipsed urban areas in the rate of drug overdose.
All of these increased risk factors put additional strain on underfunded, understaffed rural hospitals, which can, of course, have devastating effects on the health of the community.
Telemedicine Can Help
Many rural patients suffer from their isolation — distant hospitals create barriers for regular checkups, as do mountainous terrain, difficult weather, and lack of transportation infrastructure. The elderly in particular, the most common hospital patients, are less apt to go without some kind of transportation assistance.
What is Telehealth?
Telehealth is a burgeoning and exciting field that could change the game for rural hospitals.
A doctor with a video-equipped medical tablet or even just the nearest office medical computer can answer pressing patient questions without the patient even stepping out the door of their home. Video-conference software has never been easier to use, and even rural patients tend to have camera-equipped smartphones and decent LTE or wifi mobile connections.
How Does it Work?
Hospitals and healthcare groups around the country have had success with telehealth doctor visits in numerous fields. These include long-distance therapy sessions with mental health professionals, quick questions with nursing hotlines, and even full, face-to-face digital doctor’s appointments between patients and primary physicians.
Such telehealth visits have even been comprehensive enough for the doctor to prescribe medication for many conditions, or to extend medication prescription writs for already-existing health issues in still need of attention.
With a specialist shortage in rural areas, patients are often disconnected from the medical procedures they require. Telehealth can be okayed by a patient’s primary care physician to allow the patient to connect with specialists that might normally be inaccessible to them.
Regulations and paperwork are strangling most healthcare facilities, but the lower patient density means the price hits rural hospitals harder. It turns out that the average community hospital pays $7.6 million just in regulatory work — the kind of paperwork, employee man-hours, and training that has nothing to do with patient care.
HIPAA Compliance Made Easier
This is why streamlining the paperwork and EHR aspects of hospital life can net huge gains both in money and time for the hospital in the long run.
To stay HIPAA complaint for medical records, security is key. Biometric, two-factor authentication is a huge, important step toward eliminating the fuss and muss of both staff computer training and potential security breaches that could obliterate a hospital’s budget.
Rural hospitals need to embrace technology like medical cart computers with built-in RFID, barcode, smart card, and biometric capabilities. Constantly purchasing, repairing, and replacing dozens of different peripherals that “walk away” can take consistent bites out of the bottom line, which is why a medical all-in-one computer may end up being a safer investment in the long-term.
The faster and more securely clinicians can sign in to access or update EMR, the less time and money gets spent on compliance. It’s that simple.
More Reliable Computers
Rural hospitals don’t always have the cash at hand for the regular computer updates and repairs that come with an extensive medical computer system. That’s why it’s smart for rural hospital IT to look for medical computers with longer lifespans.
A consumer computer may only last two or three years under near-constant hospital use before it enters the neverending break/fix cycle, but a dedicated medical computer could last 6 or 7 years at peak condition with far less downtime during it’s run.
Seek Out Incentive Programs for Hiring More Doctors
With the previously mentioned doctor/patient discrepancy — 20% rural patients versus 10% rural doctors — attracting more clinicians to rural practice must be a priority.
Luckily, there are programs and grants that incentivize clinicians to operate in shortage-areas.
The Conrad State 30 Waiver Program allows a new doctor to skip the 2-year resident requirement and obtain a contract to work at a health care facility in Medically Underserved Areas and Health Professional Shortage Areas. Rural hospitals need to advertise this incentive, letting medical students know they can fast-track their career and help out those in need at the same time.
Rural hospitals can also help combat the drug abuse issue in their communities and find doctors, mental health professionals, and nurses at the same time with the “Patients and Communities Act of 2018.” In Subtitle H, section 7072, it states that clinicians who “complete a period of service in a substance-use disorder treatment job in a mental health professional shortage area” can have some or all of their student loans repaid.
Better Tech and More Doctors
There is no magic bullet to fix the difficult situation for healthcare in rural areas, but a combination of telehealth, better compliance technology, and clinician incentives could go a long way towards mitigating the worst of it.
Contact Cybernet today to learn about the kinds of medical computer systems a rural health care facility could truly benefit from.