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Telehealth Helps Rural Hospitals Keep Their ER Patients (And Revenues)

The University of Mississippi Medical Center's Tele-Emergency Care platform eases pressure on that hospital's ED, while helping rural health systems treat more of their own.

By Eric Wicklund

- The University of Mississippi Medical Center is the only level 1 trauma center in Mississippi. This means the hospital sees many patients transferred from rural hospitals who don’t have the rescources to treat them.

The Jackson-based hospital is using telehealth to change that dynamic, reducing the burden on its ED and helping rural hospitals keep more patients and revenues.

“It’s had a huge impact” on both UMMC and the dozens of rural hospitals around the state, says Tearsanee Davis, lead nurse practitioner at UMMC’s Center for Telehealth.

UMMC’s Tele-Emergency Care platform connects ER doctors at UMMC with nurse practitioners at the state’s rural hospitals, enabling them to use real-time audio-video to “call in” on cases. The NPs, who undergo 6-9 months of training and twice-yearly updates with UMMC, collaborate with UMMC doctors on patient care, and the two decide together whether the patient can be admitted to the hospital, transferred to UMMC or sent home.

The program has helped local hospitals recover business – and their reputation.

A study of 15 of the state’s hospitals using the platform to treat some 500,000 patients, Davis said, saw a 25 percent reduction in a hospital’s staffing costs, while the hospitals saw a 20 percent increase in admissions – patients who would have been transferred to UMMC for ultimately non-serious issues, depriving the local hospital of revenues and taxing UMMC’s resources.

Another study focused on one hospital, Davis said, and found that of 884 cases treated on the telehealth platform, 208 patients were admitted to the hospital, 68 were transferred to UMMC and 608 patients were treated and sent home. In all, Davis said, the hospital saw 101 extra patient admissions in just one quarter.

Mississippi’s situation is similar to many states with rural populations, said Davis and Matthew Rumbaugh, director of national relations ay UMMC’s Center for Telehealth, during a recent webinar hosted by the American Telemedicine Association. Roughly 60 percent of the state’s population lives in rural areas, and 37 percent live in areas classified as medically underserved. Almost 70 percent of the state’s doctors, meanwhile, live in urban or metro areas.

Davis said UMMC launched the platform in the early 2000s as a means of reducing stress on its own ED. At that time, the hospital had to bill rural hospitals for the service because there was no reimbursement for tele-emergency services.

“We couldn’t say ‘Just because we can’t get paid we can’t do it,’” she pointed out. “We saw a need and we had to address it.”

That changed in 2013, when state legislators passed a telehealth parity act for reimbursements; remote monitoring and store-and-forward telehealth were added to the list the following year, making Mississippi one of the more progressive states for telehealth support.

Davis and Rumbaugh pointed out that the platform not only reduces the burden on UMMC, but gives patients a better opportunity to be treated and stay in their own community. That improves the local hospital’s reputation with residents, improves clinical outcomes and enables the local hospital to recoup more healthcare dollars.

As a result of the program’s success, Davis said UMMC is helping its rural partners expand their services, offering platforms for telestroke, telemental health, chronic disease management and healthcare to schools. In addition, UMMC has launched a program that enables coaches and trainers at high school football games to immediately access specialists for concussion evaluation.

“These clinically driven protocols are driving high quality and standardized care” Rumbaugh said.

Dig Deeper:

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