With rural hospitals stretched thin for resources, critical access leaders and organizations are getting creative to share solutions and protect patients.
Data is the lifeblood of healthcare, but data only helps patients if it's put into action by all required parties. Initiatives like I-PASS have demonstrated how significant of an impact simple communication measures can have on enhancing care. For example, by standardizing how providers handed off patient information to other providers, I-PASS decreased patient injuries by 30 percent. But what happens when patients leave the facility? Here’s how hospitals can connect with outsiders to build an ecosystem that protects patients.
Rural hospitals receive far fewer resources than larger facilities and can struggle to meet the requirements of accrediting bodies. According to the AHA, 136 rural hospitals closed from 2010 to 2021, with low reimbursement and regulatory obstacles being the primary drivers of closures. As such, encouraging efforts like the Acute Hospital at Home model provide an optimistic way forward for these facilities. Pioneered by Illiniois-based hospital Blessing Health, along with three other facilities, they tested a combination of telehealth and in-person care tools to bring critical care to patients’ houses. According to Healthleaders, administrators integrated all the care tools on a digital platform developed by Biofourmis.
The new program improved care and put less strain on critical access hospitals. Acute Hospital at Home lowered cost per patient by 38 percent while reducing rehospitalizations and testing costs. At the same time, the conductors of the study, Brigham and Woman’s, noted increased patient activity levels. Despite the promising results, administrators said they would proceed cautiously with the program after concluding its trial run. They stated that convincing patients to be treated at home proved challenging.
Home to 105 rural hospitals, the Kansas healthcare system faced challenges communicating care information and getting resources to critical access facilities. Malea Hartvickson, the Kansas Healthcare Collaborative Executive Director (KHC), told Medplace that Kansas’s facilities suffered from siloed information and struggled to convey solutions to risk to one another, leading to patient readmissions. As a result, the KHC helped these critical access facilities share tools that reduce risk.
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These tools include medication hand-off standardization, best safety practices for care environments, patient social networks, referrals to social services, and even partnering with local fire departments for reduced risk in at-home care. Hartvickson mentioned that a COVID-19 vaccine confidence kit is the next priority for KHC.
The outcome of efforts like the Kansas Healthcare Collaborative speaks for itself. Using their set of tools, KHC lowered A1C in their diabetic patients and reduced the readmissions in their chronic care program to one.
Although telehealth is poised to address inequities in access to care, many rural communities do not have access to broadband internet. Telehealth, which includes video e-visits, remote patient monitoring, and web-based mobile health, requires a high-speed internet connection of at least 25 MB/s. With 85% of physicians surveyed by the AMA responding that they want to increase telehealth usage, rural patients face a widening gap in access to care. Fortunately, healthcare leaders and agencies are stepping in to prevent growing inequities.
As a result, several healthcare-affiliated organizations are exploring solutions to eliminate the gap between rural and urban communities. For example, the National Digital Inclusion Alliance provides a directory of partners that offer inexpensive or free technology training. Others, like Public Health Innovators, facilitate partnerships between care facilities and technology organizations to develop equitable deployment of tech resources.
However, healthcare leaders may need more resources, creative solutions, and time to realize a future of truly equitable care. As of 2021, only 72 percent of rural Americans say they have a broadband connection at home. Federal measures like the Affordable Connectivity Program offer an exciting stopgap solution for some rural patients. Still, robust internet infrastructure is the only way to ensure that telehealth patients can get the care they need.
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