- Through the use of telemedicine and telestroke in rural care, the University of Virginia (UVA) reduced 30-day hospital readmission rates by 40 percent for patients with heart failure, acute myocardial infarction, chronic obstructive pulmonary disease, pneumonia, stroke, and joint replacement.
In a subcommittee hearing by the U.S Senate on FCC’s Universal Broadband Fund and Rural Healthcare (RHC) Program, Dr. Karen Rheuban, Medical Director for the Office of Telemedicine and Director for the Center for Telehealth at UVA presented a testimony that addressed the critical importance of enhancing the RHC program.
Much of Rheuban’s testimony cited the many challenges telemedicine curbed within rural Virginia, such as easing the stress in overburned health facilities and reducing the barriers remote communities face in receiving proper healthcare.
“Telemedicine has been demonstrated to effectively mitigate the significant challenges of workforce shortages, geographic disparities in access to care, while improving patient triage and timely access to care by the right provider at the right time,” Rheuban said. “Telemedicine tools foster patient engagement and self-management where appropriate.”
The UVA Center for Telehealth helped reduce the burden of travel for rural Virginians by 17 million miles. These individuals may be encumbered by distance and high associated costs that come with visiting a major healthcare facility.
Along with reducing distance, UVA telehealth offered 60 different clinical subspecialties, facilitated more than 65,000 live interactive patient consultations and follow up visits with high definition video, monitored more than 3,000 patients at home with remote monitoring tools, and screened more than 2,500 patients with diabetes for retinopathy which leads to adult blindness.
Rural telehealth also allowed UVA to deliver over 100,000 teleradiology consults and provider-to-provider consults supported by EPIC EHR. Notably, UVA telemedicine significantly improved conditions for rural pregnant mothers and their neo-natal care needs.
“Our high-risk obstetrics telemedicine program serves rural high risk pregnant women,” Rheuban said. “We, like others, have documented a reduction in NICU hospital days for the infants born to these patients by 39 percent compared to control patients, reduced patient no-shows by 62 percent and reduced patient travel by these pregnant women by 200,000 miles.”
While UVA experienced many successful use cases, the testimony highlighted potential improvements and other challenges the RHC program must address to bring telehealth success on a national level.
Some of the largest challenges include funding that can adequately finance large broadband networks to the most remote US communities. Other healthcare experts, such as the AHA, cited the immediate need for improving RHC funding in open comments to the FCC.
The UVA Telehealth Center recommended that the RHC program continues to implement the $400 million funding cap for services, explore additional federal revenues should the $400 million be too expensive, and simplify administrative functions for providers.
Other considerations posed by the UVA telehealth include improved Medicaid and Medicare reimbursement for telehealth services, adding wireless technologies as eligible under the RHC program, and allowing emergency providers and community paramedics to be eligible for the RHC funding.
An expansion of the program’s funding and inclusion could help launch effective telehealth program nationwide, with similar outcomes to what UVA delivered to its patients.
“In summary, telehealth affords patients enhanced access, lowers the overall cost of care, and improves efficiency, quality, clinical outcomes and population health,” Rheuban concluded in her testimony. “The Rural Healthcare Program is a critical underpinning of a modernized healthcare delivery system in the digital era and as such must be continued, expanded and further modernized to fulfill the promise of healthcare in the digital era.”