Physician viewpoint: Telemedicine could save small hospitals

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Small hospitals are least likely to have telemedicine, though they're also the ones that would benefit most from it, two physicians and a researcher at Boston-based Harvard Medical School argued in an opinion published Aug. 27 in JAMA Health Forum.

The authors say small rural hospitals often transfer their emergency department patients to urban specialty care centers, complicating the care journey and potentially costing lives. The authors offer telemedicine as a multi-pronged solution: it allows patients to receive care closer to home, prevents care inequities, helps small hospitals retain their patients and can improve hospitals' finances. 

Telemedicine is rare among small hospitals, though. Such hospitals are usually reluctant to adopt it, fearing they can't afford the upfront costs and low reimbursement. 

The solution could lie in policy that makes the three following changes, according to the authors: ensuring reimbursement for acute care service are made directly to the ED where the patient was seen, increasing payment for telemedicine consultations at small hospitals and pooling demand and consolidating efforts among coordinating centers for smaller hospitals. 

The authors said making these changes would "help to ensure that patients who seek care at small rural hospitals are not left behind by the shift to virtual care."

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