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American Association for Physician Leadership
American Association for Physician Leadership

Telehealth Is Improving Health Care in Rural Areas

by Marc Harrison

August 13, 2019


Many residents of rural areas are hundreds of miles from the nearest hospital, so technological advancements in health care like telehealth have helped.

In rural America, patients are often hundreds of miles from the care they need. Community hospitals, with low volumes and limited budgets, usually don’t have specialists on staff. And even when they do, there are often too few to ensure constant coverage.

Patients are frequently transferred to distant acute care centers to receive specialized care. Local caregivers don’t get the opportunity to learn from specialists about caring for complicated patients. Similarly, social workers, crisis workers and care managers for chronic diseases are sometimes not available in smaller communities, requiring patients to travel hours for basic mental health and primary care.

Telehealth, which uses secure video and audio technology to connect care providers in smaller health care facilities with specialists in large hospitals, transforms those situations. The patient receives expert treatment locally without the added risk and cost of a transfer to a bigger hospital. Local hospitals retain vital revenue and enhance their services. Community members get better care.

Intermountain Healthcare operates 24 hospitals and 160 clinics in Utah and Idaho. And its Connect Care Pro operation provides 40 telehealth services in seven western states to many facilities that are not part of Intermountain. We have a 24/7 telehealth center in Salt Lake City with a full-time staff, plus about 500 care providers on call who are in a wide range of medical specialties.

The benefits to patients are profound. We’ve experienced a significant decrease in unnecessary emergency room and urgent care utilization among patients who’ve used the service. And, as the health industry moves toward a value-based model that rewards providers for achieving better outcomes at lower costs and away from a fee-for-service model that bases payment on the volume of services provided, telehealth allows the best use of resources to provide high-quality care at the lowest possible cost.

Our use of Connect Care Pro has also contributed to decreased mortality and length of stay in our intensive care units, improved door-to-needle time for stroke patients, decreased evaluation time for mental health patients in crisis and the number of unnecessary and costly patient transfers for both newborn and ICU patients. With access to the latest best practices and standards of care, Connect Care Pro also promotes standardization of care and a pathway to constant learning for caregivers.

One challenge to scaling telehealth to improve health care nationwide is that the relevant payment policies and reimbursement models often prevent providers from receiving payment for telehealth services. So large, integrated health care systems are left to cover the costs.

Payment policies and reimbursement models need to catch up with this major advance in health care technology and delivery, which works best in a prepaid, or capitation , model vs. a fee-for-volume scenario. There is discussion in Washington about creating parity in payment, so that care providers would be paid the same for a digital visit as for an in-person visit. But so far only limited telehealth services are being covered by the federal government and other payers.

In keeping with our tradition of data analysis, Intermountain is documenting the results of our telehealth initiatives, and we’ll share them broadly as the initiatives evolve. Stay tuned.

Copyright 2019 Harvard Business School Publishing Corp. Distributed by The New York Times Syndicate.

Marc Harrison

For over 45 years.

The American Association for Physician Leadership has helped physicians develop their leadership skills through education, career development, thought leadership and community building.

The American Association for Physician Leadership (AAPL) changed its name from the American College of Physician Executives (ACPE) in 2014. We may have changed our name, but we are the same organization that has been serving physician leaders since 1975.


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