There is a crisis in rural America. More than 80 hospitals have closed across the country since 2010 and more are slated to follow suit. In fact, more than 40 percent of the nation’s hospitals are operating in the red and struggling to stay alive. When rural hospitals close, they leave dangerous gaps in care for the citizens left behind. Telemedicine can help to close those gaps and prevent high risk health scenarios from developing.
In the state of Alabama alone, 12 hospitals have closed since 2011. Six of them served rural populations. The latest report from the Chartis Center for Rural Health says that nationwide, 673 rural hospitals are barely staying live and staving off closure. That’s a health crisis waiting to happen; it’s no secret that rural populations tend to be older, poorer and sicker than others. Consequently, they need more healthcare more frequently.
The reasons for rural hospital closures are complex. They can include acquisitions by larger health systems and market consolidation, diminished patient volume, regulations causing reimbursement challenges, states that have not expanded Medicaid, high percentages of uninsured patients, and sicker, older populations. Regardless of the reason, when a rural hospital closes, it spells trouble for the population left behind. Although it may begin with a hospital stay in another town, the personal challenges may well continue if rehabilitation, physical therapy or skilled nursing care is needed. Those extended stays place additional pressure on the patient and family, not to mention additional costs for transportation and other personal and logistical arrangements.
A good example is the closure of Copper Basin Medical Center in Ducktown, Tennessee. The hospital closed in 2017. Now the nearest hospital is across state lines in Murphy, North Carolina and Blue Ridge, Georgia. Nearly 1,000 people live in Ducktown. Not only do they not have a hospital, they don’t have an emergency room, walk-in clinic or urgent care center. On a good day, it’s a 27-minute drive from Ducktown to Murphy, NC and a 25-minute drive to Blue Ridge, GA. That can be a fatal distance for someone suffering a heart attack or stroke. It can also cause problems for patients covered by health plans that aren’t portable across state lines.
There is one answer to this looming crisis – telemedicine. The adoption of telehealth (the general term for all types of telemedicine and telepsychiatry) is growing across the country due to its promise and its power to deliver health care services to people like those in Ducktown. Telemedicine can deliver a physician “virtually” directly into a patient’s home. It can give patients access to mental health and behavioral health services without having to travel. With a WiFi connection, computer and/or smart phone, patients can consult with physicians who are many miles away. It delivers preventative care that can help to prevent acute health events and reduce the need for emergency room visits. In fact, the American Medical Association estimates that 75 percent of all physician, urgent care and emergency room visits would be classified either as unnecessary or manageable when handled by telemedicine.
Patients want telehealth services. Certainly, they are needed when a local hospital ceases to exist. However, even when that untimely event does not occur, patients regularly express their preference to consult with a doctor via telehealth services. When surveyed:
- 78% of those willing to have a video visit with a doctor would be happy to manage chronic conditions via video consults with their PCP
- 65% were very or somewhat interested in conducting video visits with their PCP
- 60% of respondents said that they would be willing to use them to manage a chronic condition
- 52% of adults reported that they were willing to participate in post-surgical or post-hospital-discharge visits through video.
The best telehealth systems allow patients to search for physicians of many different specialties and build their own healthcare teams. The best telehealth platforms allow providers to build patient volume without increasing overhead costs. It allows them to set hours of availability, chart and prescribe over the telehealth platform. Any time that remote patient monitoring can be put in place, it reduces costs. When surveyed, 33 percent of providers said they experienced “extensive cost savings” through remote telemedicine services.
The healthcare crisis in the United States isn’t going to be resolved any time soon. Tragically, rural hospitals are going to continue to close leaving thousands of people without healthcare. Fortunately, telehealth services are ready to be implemented. Children, adults and seniors can access physicians for physical and mental health care and the remote monitoring of chronic conditions. The time has come to close gaps in care with telehealth services.