BLOG: Telemedicine is the Prescription for What Ails Rural Healthcare

By Chris Gallagher, MD, Chief Executive Officer, Access TeleCare

In Texas alone, nearly one out of every 10 hospitals are at risk of closure, twice as many as before the start of the COVID-19 pandemic, and most of those at risk are in rural communities, according to a Kaufman Hall report published in October 2022. Rural Texas hospitals have a 26% risk of closure, compared with a 5% risk for urban facilities.

And Texas isn’t unique. More than 135 rural hospitals across the country closed between 2010 and 2021, with a record 19 in 2020, according to the American Hospital Association.

These closures don’t have to become commonplace.

The pressures on rural hospitals are certainly immense, and their financial vulnerabilities are significant. But telemedicine can help. Telemedicine isn’t a panacea, but it can be an effective treatment for what ails rural health care.

Specialty telemedicine done right can give rural hospitals an almost immediate tool to retain more patients, reduce transfers, increase case mix index, decrease length of stay, strengthen patient loyalty, enhance clinician satisfaction and recruitment, and deliver high-quality outcomes. 

The result is that rural hospitals can not only keep their doors open, but they can also truly compete with larger tertiary facilities, expand their services, serve more patients, maintain services that typically lose money, such as labor and delivery, and ultimately more meaningfully contribute to their community’s vitality and economic well-being. 

My team has partnered with (and I choose the phrase “partner with” purposefully) a rural hospital in East Texas for almost a decade to help solve challenges that afflict nearly all rural hospitals: patient outmigration to larger urban hospitals, inability to recruit specialty physicians, clinician burnout, and financial losses.

Since our partnership began in 2013, we have built and sustained five specialty telemedicine service lines. When local patients need care for a neurological condition, such as a stroke, this hospital can provide it. When local patients need care for kidney failure, this hospital can provide it. When local patients need ICU-level care for severe COVID-19, this hospital can provide it. And the same is true for patients with COPD needing pulmonary care and those with complex or antibiotic-resistant infections needing specialty infectious disease care. 

These services all are delivered via telemedicine. The physicians providing the care are in other Texas cities, in California, in New York, anywhere in the United States. When they come on the screen, however, it is as if they are in the room with the patient and the nurse.

This hospital began its telemedicine journey with telemedicine intensivists to cover its ICU at night. With the success of this service line, the hospital looked at its outmigration and financial data and identified neurology as the next area of opportunity. Today, the hospital is a designated stroke center, all with teleNeurology coverage. As the on-site nurses, physicians, and other clinicians became more familiar and accustomed to working with the telemedicine physicians, the hospital identified other opportunities for additional growth, including infectious disease, nephrology, and 24/7 hospitalist services. 

This hospital is thriving. It has bucked the trend of rural hospital financial losses, service line shutdowns, and closures. 

When a community loses its rural hospital, it doesn’t just lose accessible emergency, primary, and specialty health care. It loses an employer and economic engine. It loses a philanthropist and community advocate. It loses something that makes the community attractive to businesses looking to relocate or start up. 

We can’t change rural communities’ demographics, and policy change often occurs slowly. Rural hospitals and their communities can’t wait. Specialty, inpatient telemedicine is available today for any rural hospital to avoid becoming another closure statistic and to continue serving its community today, tomorrow, and well into the future.  

Learn more about specialty telemedicine in rural hospital settings by visiting the Access TeleCare Team at ATA2023, Booth #414.

Chris Gallagher, MD, is a board-certified cardiologist and serves as Chief Executive Officer of Access TeleCare, the largest national provider of acute care telemedicine.