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Rural Hospital Challenges

Battling the Unique Challenges Faced by Rural Hospitals

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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.

The Recession

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.

Streamlining Compliance

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.

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Reducing Unnecessary Hospital Visits with Telehealth

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It’s no secret that medical facilities are understaffed, overcrowded, and often underfunded. Patients seem to be shipped in by the truckload, and factors like staffing shortages and doctor burnout have many professionals worrying about increased wait times and decreased patient satisfaction.

Unnecessary hospital visits only expound these common problems, choking up emergency departments, urgent care facilities, and even doctor’s offices with patients who would have been just fine at home.

Luckily, the industry of telehealth has made great strides in reducing these visits, especially in the fields of home care, telemonitoring, and chronic illnesses. Add to that the possibility that Centers for Medicare and Medicaid Services (CMS) may be expanding the number of telehealth services covered by Medicare, and you’ve got a full-blown industry boom brewing.

But how can hospitals and medical practices leverage telehealth to save time, money, and mental energy?

Where is telehealth most effective?

Telehealth Reduces Nursing Home Hospitalizations

Nursing homes are only growing more crowded as one of the largest generations — the Baby Boomers — age. And since the elderly are frequently hospitalized for numerous different reasons, nursing homes are a perfect launching point for telehealth services.

Some nursing homes have already partnered with medical groups and vendors to use long-distance doctor’s visits to lighten the load on nearby hospitals.

Central Island Healthcare, a nursing facility in New York, had telemedicine experts train their nurses. These nurses were then able to use medical tablets and medical grade PCs to give their nursing home residents long-distance doctor visits without leaving their rooms. Instead of constantly shuttling nursing home residents to and from hospitals, the nurses were able to help the patients get diagnosed and even prescribed medication over a Skype-style video chat with a doctor.

This reduced hospital visits of nursing home residents from 25 a month to 14. Doctors, over medical computers, were able to see the patients and help them, but without all of the attendant hassle for both parties.

Another added benefit of telehealth for elderly patients — they’re unlikely to contract a nosocomial (hospital-acquired) infection from the comfort of their own rooms. And considering that the elderly are typically at the most risk from common hospital-acquired infections like pneumonia, telehealth could literally save lives.

What About Nursing Hotlines? Do They Work?

Perhaps one of the earliest forms of telehealth is “telephone triage,” more commonly known these days as a “nurse hotline.” Nurse hotlines allow patients to call a number — usually provided by their insurance — to get quick medical advice from a nurse.

There’s little doubt to their efficacy — a study by the University of Southampton in the UK found that a well-staffed nurse hotline can reduce the number of both ambulance dispatches and hospital admissions in the area, with a relatively low error rate.

However, telephone triage lacks the greatest strength of modern telehealth: nurses aren’t allowed to diagnose conditions or prescribe medication. For those procedures, a doctor is required.

Plus, the nurses are only able to talk to the patient over the phone, and can’t see them or be shown symptoms or wounds. And while nurses are incredible at their jobs, that’s a difficult position for any clinician to be in. Modern telehealth devices far surpass the limitations of a simple phone call, and smartphones, tablets and computers can all be used to upgrade the old telephone triage hotlines into full-scale telehealth services.  

Telehealth Monitoring Leads to Fewer Visits to the Emergency Room

Close to 75% of all healthcare expenditures are spent on chronic illnesses. They’re also the cause of 70% of the deaths in the United States.

However, telehealth monitoring may be a highly effective weapon to combat this problem. Telehealth monitoring uses a device to record vitals like heart rate, blood pressure, and blood sugar. A home monitor that is integrated with a medical device computer then sends the information to the doctor, who is able to monitor sudden drops and changes. With doctors receiving real-time updates, it’s far easier to treat flare-ups and complications of a patient’s diagnosed chronic illness.

This monitoring can also take the form of digital doctor’s appointments, where the doctor speaks to the patient over a video call. The appointment then goes much like any regular in-person visit, especially when the doctor already has all the patient’s vitals courtesy of the telemonitoring system.

An exhaustive report of multiple studies from medical groups, universities, and hospitals found a wealth of useful data about how telemedicine, particularly telehealth monitoring, made a huge difference to cost, engagement, hospital admissions, and mortality rates for patients with chronic illnesses like cancer, diabetes, arthritis, pulmonary disease, and heart disease.

Over multiple studies, mortality rates from chronic diseases monitored by telehealth were reduced anywhere from 15% to 56% depending on the study. After having a stroke, patients who used telehealth monitoring had a reduced mortality rate of 25% for the first year after the original stroke.

The study concluded that a massive wealth of evidence points to telehealth “reducing hospitalization and emergency department visits,” “preventing and/or limiting illness severity,” which resulted in “improved health outcomes.”

A separate study of veterans with chronic illnesses found a 19% reduction in hospital admissions and a 25% reduction in the number of bed days. They also found that the telehealth treatment cost less, and produced excellent satisfaction scores from the veterans who used it.

What Does the Future of Medicine Look Like?

The future has already arrived for many telehealth technologies.

Dedicated virtual care centers, facilities whose sole purpose is to provide long-distance care for patients, already exist. Mercy Virtual, a dedicated virtual hospital in Chesterfield, Missouri, doesn’t have a single patient bed on the premises. Instead, nurses, clinicians, and doctors in the facility (or working remotely) communicate solely via medical computers to diagnose and treat patients.

Another sci-fi tech, virtual reality, is already being used to train doctors and perform long-distance surgery. In addition, there is some evidence that virtual reality immersion techniques, used from the safety of home, could be used by psychiatrists and patients to treat disorders like anxiety, depression, PTSD, and even intense phobias.

Obviously, some of these more advanced techniques are in their infancy, but it does show that telehealth is being taken seriously as a treatment style that could have huge positive benefits.

Telehealth Today

It’s clear that healthcare has a problem with rising costs, patient wait times, and clinician burnout. Luckily, cutting-edge telehealth technology like camera-equipped medical tablets and medical computers, along with telehealth training, could take a massive load off of overworked healthcare professionals.

Right now, only 15% of physician practices are using telemedicine. Any new technology takes time to proliferate, but with telehealth showing huge leaps in cost savings, patient health, and reduced hospital visits, it’s a technology that simply can’t be ignored.

How can your practice benefit best from telehealth? Is your medical computer equipment up to the task of the streaming, video-recording, multimedia demands of the burgeoning telehealth future?

To find our more information contact Cybernet here.