A session on rural telehealth attracted an eager, late morning crowd at this year's Society for Healthcare Strategy & Market Development Connections conference, which officially started on Sunday evening.
Michael Adcock, administrator, Center for Telehealth at the University of (Jackson) Mississippi Medical Center alongside Jeff Cowart, senior vice president of market development and public affairs, University Health System, Shreveport, La., walked us through why telehealth is not just a nice thing to do. "It is actually a very important business strategy,” Cowart says.
They also discussed how UMMC has been able to connect the most isolated patients in the state to specialists miles away and why other systems should follow suit.
“This is not just a rural issue. Telehealth can help solve issues to access that have nothing to do with distance from specialists. There are medical centers in urban areas that don’t have the specialty coverage they need,” says Adcock. “We do know this. It’s going to be big. It’s already big and it’s going to get bigger.”
For those that still weren’t convinced, Adcock presented some startling numbers. Since 2010, 48 rural hospitals have closed and in 2016, 283 rural hospitals are in danger of closing. And in Mississippi, 53 of its 82 counties are located more than a 40 minute drive away from specialty care. Providers had to get in their car and travel to patients, because physicians didn’t want patients to have to come to them.
UMMC launched its first live telemedicine program in 2003 with Telemergency, which Adcock does not recommend starting with, unless staff can field 24-hour calls 365 days a year, an unpredictable and tall task. It has since grown to a Telehealth Department with 55 employees who focus solely on telehealth with more than 200 specialists offering 35 different specialties – all virtually.
“What we’re trying to do in Mississippi is push primary and specialty care out as close to patients’ homes as possible,”says Adcock. “It allows us to maximize our resources, especially our specialists.”
And the medical center is succeeding. They have had nearly 800,000 telehealth encounters since 2003. Not only is UMMC connected to 15 rural hospitals across the state, they provide telehealth services to six prisons throughout Mississippi, offer tele-mental health to colleges, universities and mental health clinics and have had tremendous success with their remote patient monitoring diabetes program.
The Mississippi diabetes telehealth network was started to combat the diabetes epidemic in the state using what Adcock calls the three E’s: education, engagement and empowerment. Participants in the pilot program received a tablet preloaded with individualized educational material. Patients were required to participate in daily health sessions on the tablet that included blood sugar and weight monitoring.
Preliminary results for the first 100 patients in six months amounted to a 96 percent medication compliance rate, compared to the average of below 60 percent in Mississippi and no hospitalizations or emergency department visits as a result of diabetes in sixth months.
Adcock has seen first-hand the power telehealth has played in the rural Mississippi delta, and says while rural hospitals can benefit the most from a robust telehealth strategy, all of health care needs to realize the importance the technology can play.
“We cannot continue as health care workers to influence the behavior of someone by seeing them once every three months,”he says. “If we can make telehealth work in Mississippi, you can make it work in your state.”