Better care at a lower cost: How cloud and telehealth technology can transform small communities

Many community hospitals and critical access hospitals have struggled in recent years to remain financially viable and clinically relevant to their communities. At the same time, these facilities are often the only medical resources for rural communities and for towns and cities far from population centers. They are a vital link in the healthcare chain.

Fortunately, several technological developments in recent years can help these facilities, both financially and clinically. In particular, cloud-based software-as-a-service offerings and telehealth will help smaller facilities add big-hospital capabilities and medical expertise without adding big costs.

First, let’s talk about cloud computing, which, in many ways, seems designed specifically for these folks. Cloud-based technology frees a facility from the headaches of maintaining a data center while greatly expanding its IT capabilities because the cloud can spread costs across many customers. Security in particular is greatly enhanced for these users because security expertise is scarce and expensive, but cloud computing enables security resource sharing across a customer base.

Also, cloud-based EHRs don’t require the facility to do its own software updates and upgrades; the vendor takes care of that. It also obviates the need for capital investment, leaving those dollars free to invest in other patient care priorities.

Furthermore, there are new cloud-based software-as-a-service analytics offerings that allow small facilities to adopt high-level analytics capabilities. One interesting new choice is imaging analytics, which identifies patients at risk for a variety of diseases by analyzing existing imaging studies at the pixel level. This is possible because most diagnostic images include more than just the clinically targeted area. It’s a fast, affordable way for smaller organizations that have captured patient images they can use to identify clinical risk in their patient populations. As outcomes-based reimbursement contracts become more common, this will be a useful addition to community hospitals’ strategy.

Telehealth can bring expertise to even the most remote location
The sophistication and ease of adoption for telehealth continue to increase. There are many options for telehealth programs, and the cost is comparatively low. The key to make this useful will be the extended expertise that you can bring to the local community.

There are two ways I see this technology working for the benefit of smaller communities. First, e-visits with primary care physicians and specialists will reduce the need to travel long distances for care. Secondly, the ability to use video technology for consultations with specialists will be incredibly useful for local physicians and nurse practitioners, particularly in emergent or urgent care settings.

Let’s say that a young teenager comes into the local emergency room after hitting his head hard during a skateboard mishap. He seems okay, but this particular boy had a hard knock to the head a few weeks before during football practice. The CT scan is unremarkable, but the physician on duty is worried. He does not have extensive experience in neurology and head injury, and he’s not sure what subtle signs he might be missing. He knows the family’s resources are limited and a transfer to the children’s hospital 150 miles away would be difficult for them, so he doesn’t want to do that unless it is warranted. But he also doesn’t want to overlook the possibility that the boy needs a higher level of follow-up care than he can provide.

With fairly simple technology and a pre-existing relationship with a tertiary care facility, the physician can share the diagnostic images and other data with a pediatric neurologist and get advice from a true expert. And new products can record video of the boy and transmit an encrypted file to the cloud, where the neurologist can view it instantly to look for those subtler signs of head injury or trauma. With the help of the specialist, the ER doc will have better data for making the transfer decision.

That same technology could be used to provide follow-up care to a patient recovering far from a medical center. The patient could use a cell phone to create a video of herself going through a set of movements prescribed by her physician and transmit the video in an encrypted format to the cloud. The physician could then check the patient’s progress and discuss further rehabilitation or other treatment options in real time with the patient, without the inconvenience of that long drive to the doctor’s office and time away from work or family.

With the right technology, a very high level of medical expertise could be available even in the smallest clinic or hospital.

While these technologies can’t solve all the problems faced by small community hospitals and clinics, they can erase some of the difficulties of providing high quality care when resources are scarce.

More articles on telehealth:

Intermountain Healthcare launches telehealth service for Utah, Idaho patients
VA to establish 5 mental telehealth hubs 
Less than 1% of Medicare rural beneficiaries receive telehealth services, study finds 

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