How rural hospitals are responding to coronavirus

Throughout the country, hospitals and health systems are vigilantly and creatively working to prevent the spread of the coronavirus. While large health systems such as Intermountain Healthcare and Providence St. Joseph Health have the resources to roll out telehealth services, rural hospitals are relying on staff.

Newton (Kan.) Medical Center is among the rural hospitals across the country that does not have virtual services and telehealth services within its workflows, a spokesperson told Becker's Hospital Review.

A study from Connected Nations released March 12 explored the use of telehealth in rural areas as COVID-19 continues to spread. Researchers found that a lack of funding for program expansion, the need for improved broadband access and disparate reimbursement from insurance and Medicaid telehealth services to be the three major challenges affecting rural health networks from using telehealth.

In other areas of the country where COVID-19 has not been detected, rural hospitals are still discussing how to stay ahead of the virus. At Caribou, Maine-based Cary Medical Center, leaders are working to ensure the proper protocols are in place for if the virus expands to their area.

"At this time, we are not using virtual care services, but we don't have any actual cases yet," said Regen Gallagher, DO, chief medical and compliance officer at the rural hospital. "Our preparations center around all the other stuff. So, putting in plans to deal with surge and the triage of patients."

Rural hospitals are also relying on emergency response drills to fight the spread of the coronavirus rather than implement virtual care services, which might not always be available. Woodsville, N.H.-based Cottage Hospital is closely monitoring supplies to ensure staff have the necessities to complete their jobs safely. When asked how the rural hospital is preparing for the virus, Chief Nursing Officer Holly A. McCormack, MSN, RN, stressed the importance of communication.

"In reply to your question about responding and preparing for COVID-19 in a rural hospital it is important to know that the first three cases of COVID-19 in New Hampshire were diagnosed in our county," she told Becker's Hospital Review. "While they were not at our facility, it demonstrated the crucial nature of the situation. At Cottage Hospital, a rural hospital servicing 26 towns between two states, we know we have to be ready for whatever may come our way. For this reason, our facility routinely drills in emergency preparedness procedures. It is necessary to be able to stand up an incident command at any given moment."

"However, that is only a small piece of the puzzle," she continued. "Another key piece is to be informed and share information with all members of the organization. It is important that all staff have information to keep themselves and the patients safe. Each morning in safety huddle, we review any changes or updates and answer any questions. The clinical directors are reviewing the use of personal protective equipment as well as negative pressure environments with staff. We want everyone to feel comfortable and confident in the usage."

In the wake of the coronavirus epidemic, government officials are receiving more pressure to build a nationwide broadband system. A group of nonpartisan organizations, including the National Governors Association, National Conference of State Legislatures, Council of State Governments and United States Conference of Mayors, has called on the federal government to expand its investment in a nationwide broadband infrastructure.

The scarcity of broadband access in rural communities has left some patients unable to virtually consult with their healthcare providers. Research published in the Annals of Internal Medicine found that as distance between cities increases, the percentage of broadband access subscribers decreases, with broadband rates of 96 percent in urban countries, 82.7 percent in rural counties and 59.9 percent in counties with extreme access considerations.

"The need for greater federal investment in the nation's broadband infrastructure has never been more apartment," said the National Governors Association in a press release on behalf of all the organizations. "Connectivity is essential to unleashing economic potential, promoting job growth and ensuring small business participant in the digital economy. We need ubiquitous, affordable broadband to truly unlock the potential of new technologies for healthcare advancement and smart infrastructure."

More articles on telehealth:
Spectrum Health & more offer free virtual screening for COVID-19
How telehealth is being used to limit the spread of coronavirus: 6 things to know
How Providence, Kaiser Permanente, Intermountain are using telehealth to treat patients amid coronavirus outbreak

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