Telemedicine Helps Isolated Hospitals in Rural America 

Eli Saslow, a Washington Post reporter, tells us, “The number of ER patients in rural areas has surged by 60 percent in the past decade, even as the number of doctors and hospitals in those places has declined by up to 15 percent. Dozens of stand-alone ERs are fighting off bankruptcy. Hundreds of critical-access hospitals either can’t find a doctor to hire or can’t afford to keep one on site. Often it is a nurse or a physician assistant left in charge of a patient.”[1]

“If anything defines the growing health gap between rural and urban America, it’s the rise of emergency telemedicine in the poorest, sickest, and most remote parts of the country, where the choice is increasingly to have a doctor on screen [from a nearby urban hospital] or no doctor at all.”

An example of such a telemedicine emergency service is Avera eCare in Sioux Falls, SD, which provides a telemedicine center providing remote emergency care for 179 hospitals over 30 Midwestern states. “Physicians for Avera eCare work out of high-tech cubicles instead of exam rooms. They wear scrubs to look the part of traditional doctors on camera, even though they never directly see or touch their patients. They respond to more than 15,000 emergencies each year by using remote-controlled cameras and computer screens. . . .”

“In less than a decade, . . . [this] virtual hospital has grown from a few part-time employees working out of a converted storage room into one of the country’s most dynamic 24-hour ERs, where a rural health-care crisis plays out on screen. Each month the monitors show an average of 300 cardiac episodes, 200 traumatic injuries, 80 overdoses and 25 burns. There are patients suffering from heat stroke in South Texas and frostbite in Minnesota — sometimes on the same day. There are drowning deaths in summer, gunshot wounds during hunting season, car accidents on icy roads, and snakebites in spring.”

“Telemedicine [has] helped [rural] hospitals retain and recruit doctors because it gave them more support and allowed for more time off. It also allowed [these rural] hospitals to treat more patients on site rather than having to transfer them to bigger facilities, resulting in increased billing charges and more hospital income.”

This virtual hospital, at the other end, has “15 doctors and 30 emergency nurses who rotate through shifts . . . , and while all of them have trained for years inside regular ERs, nothing compared to the intensity of the industrial park. During one 24-hour shift, they often saw more critical cases on screen than most ER doctors encountered in a month: an average of one severe heart attack each shift, one suicide attempt, two pediatric emergencies, three traumatic injuries, four intubations, and five patients whose hearts had already stopped beating and needed immediate resuscitation.”

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[1] Saslow, The most remote emergency room: Life and death in rural America, Wash. Post (Nov. 16, 2019)

 

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dwkcommentaries

As a retired lawyer and adjunct law professor, Duane W. Krohnke has developed strong interests in U.S. and international law, politics and history. He also is a Christian and an active member of Minneapolis’ Westminster Presbyterian Church. His blog draws from these and other interests. He delights in the writing freedom of blogging that does not follow a preordained logical structure. The ex post facto logical organization of the posts and comments is set forth in the continually being revised “List of Posts and Comments–Topical” in the Pages section on the right side of the blog.

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