Reducing the rural patient's burden by expanding access with telehealth

Over the past several years, as debate about the future of healthcare has raged, “quality, cost, access” has become the mantra for thought leaders seeking strategies to render our system sustainable.

But among the components of this triumvirate, “access” seems to have been given the least amount of attention. Yet, access to healthcare – quality, cost-effective healthcare – is a significant challenge to many Americans, particularly the 20 percent of our population residing in rural areas.

For these individuals, seeing a specialist typically requires them to travel to a city where the majority of clinicians are located. Only 11 percent of specialists, as a matter of fact, practice in rural communities. Technologies supporting telehealth can greatly reduce the burden on these patients and provide access to care that previously would have been difficult, if not impossible, for them to obtain.

For the past two-and-a-half years, I have participated in a telehealth program that connects my practice in Pittsburgh at UPMC with a hospital and community two hours away in western Pennsylvania. To date, I’ve conducted more than 150 virtual encounters ¬– both pre-op and post-op. And, contrary to popular opinion that Americans are comfortable only with face-to-face visits with their physician, my patients have responded extremely favorably to gaining convenient access to my care – without the burden of travel and the out-of-pocket expenses that accompany it. Patient satisfaction scores for remote encounters stand at 95 percent, and each patient saves an average of $120 per tele-encounter (factoring in gas, time from work, tolls, etc). And my results aren’t exceptional. One of my partners at the telehealth clinic is a skilled breast surgeon and has experienced similar patient benefits.

Telehealth helps close the gap between the concentration of specialists in urban centers and the millions of individuals who live in rural areas. Over time, the development of and increased reliance upon advanced diagnostic and therapeutic technologies created the need for centralized care-delivery locations, since few smaller healthcare organizations can afford to invest in these expensive technologies. Nor is it feasible to transport this equipment to and from outlying patient care centers. In this regard, telehealth can increase access not only to specialists, but also to the diagnostic and therapeutic technology that supports optimal care.

In my current telehealth practice, I consult with both pre- and post-operative patients, while simultaneously collaborating in real-time with the rural clinicians who are onsite with the patients. Laboratory testing, as well as procedures and diagnostic studies, are performed at the rural hospital, and results are sent to me digitally via the telehealth network.

Increasing patient access to quality medical services is a primary focus of today’s healthcare industry, and telehealth is a valuable tool to help accomplish this mission. Ultimately, we can remove the added travel burden on rural patients, while increasing the quality of care they receive. Most importantly, we are keeping the care in their community where it belongs.

Andrew Watson is the Medical Director for the Center for Connected Medicine in Pittsburgh.