How Telemedicine Can Help Rural Hospitals Solve More than Staffing Challenges
At the AHA Rural Healthcare Leadership conference, we spoke about telemedicine and heard from hundreds of rural hospitals about their challenges serving rural communities: aging populations, increased substance abuse issues, and reliance on Medicaid and Medicare services. And, a lot of what we heard sounded like this:
“Can’t get them here.”
“Won’t move here.”
“We’re too small to attract them.”
“We’re too boring for them.”
Who are “them”? Physicians, of course. There are significant shortages for neurologists, hospitalists, intensivists, and psychiatrists, among others. These specialists are educated in urban areas and tend to stay there after their education is complete instead of moving to smaller towns like Saranac Lake, NY, Lutcher, LA, or Wickenburg, AZ.
Many of these rural hospital leaders are interested in how telemedicine could help alleviate these staffing shortages, but they are also looking at locum tenens solutions, or even “grow your own” strategies (paying off medical school debt and offering other incentives to get physicians to return to their communities after residency).
The benefit of hiring locum tenens physicians to fill these gaps is well understood. But, so are the costs – which can be overwhelming for a small, rural hospital, and won’t ensure night or weekend coverage. And, “grow your own” is a longer term strategy, not a quick fix.
How can telemedicine help rural hospitals?
Keep patients local. Huntsville Hospital created a hub and spoke model for their stroke program using telemedicine. Patients who present with stroke symptoms are seen by a board-certified neurologist at their local hospital over a telemedicine cart, allowing diagnosis and treatment to be much quicker than if they had to be transported to the hub hospital. And, if they are transferred? They often see the same neurologist they saw on the screen earlier.
In many rural areas, family members travel hours to see loved ones in the hospital. This is a hardship for many because of costs for gas, hotels, and meals. There are also lost wages to consider. Telemedicine enables the family to stay together, closer to home, decreasing stress and expenses at a vulnerable time.
Provide better access to specialized care. With the scarcity of some specialties, such as neurology and psychiatry, many rural hospitals just don’t have them on staff or on call (or even in the same county.) With telemedicine, board certified specialists are minutes away, not hours.
Retain current staff. Because telemedicine helps keep patients local while providing them better access to specialized care, rural healthcare physicians and nurses have higher job satisfaction. This is because they are helping their neighbors and friends where theylive, instead of transferring patients out of their communities.
Decrease recruiting costs. Many times we reach out to hospitals who are advertising for neurologists or psychiatrists to understand if telemedicine could help. Some of these jobs have been posted for six months or more. This open-ended recruiting costs money and time. It can be demoralizing for human resource staff, too, as they try to compete with more urban areas but can’t match salaries, can’t offer a robust economy for the physician’s spouse to gain employment, or can’t guarantee flexibility of scheduling.
Stay in business. We’ve heard from many client partners that if it were not for the telemedicine programs they have established, they would have had to shut their doors. With so many rural hospitals going out of business, whole communities suffer because the hospital jobs disappear, too.
We met some visionaries, too, who are already using telemedicine to solve some of the challenges faced by rural hospitals. They are growing footprints and increasing revenues, undergoing a “reconceptualization” of their mission.
Are you faced with some of these same issues? Let us know if you would like to talk about how telemedicine can help.