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July 22, 2014 01:00 AM

Guest Commentary: Telemedicine a necessary investment for rural hospitals

Bryan Coffey
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    Coffey

    Hamilton County Hospital is a 25-bed critical-access hospital serving about 3,000 people in southwest Kansas. Like many rural hospitals, a number of our service lines had been eroding because we couldn't make them financially viable. When I became CEO here, many patients had to travel four to five hours each way to either Wichita, Kan., or Denver to see specialists. For elderly patients, that usually meant a one-night stay in those cities, adding to the cost and inconvenience.

    That's all changed now, thanks to telemedicine. Hamilton County now has a telemedicine robot that allows neurologists and other specialists to beam in from our tertiary-care partners: Swedish Medical Center in Englewood, Colo., and Wesley Medical Center in Wichita. With telemedicine, residents in our small community can get the same high-caliber care they would receive in large metropolitan hospitals.

    Before telemedicine, Hamilton County was a classic “stabilize and ship” hospital, where many patients were routinely transported to city hospitals. These facilities often got clogged with cases that really could have been handled locally. Now, for example, a remote neurologist can quickly determine whether a stroke patient can receive tPA treatment at our hospital or needs immediate transfer. It's a technology that will allow Medicare and private payers to save millions by eliminating unnecessary transport.

    In addition to our initial telestroke and teleICU programs, we're now offer remote primary-care, pediatric and dermatology consultations—and even remote obstetrics consultations for pregnant women in their first trimester. While our robot can't deliver babies, it does have the ability to monitor vital signs, assess stroke symptoms, and take EKGs and sonograms that are shared with the remote physician in real-time.

    Many hospitals balk at purchasing or leasing a robot, fearing that it comes with a Star Wars-type price tag. But here's the good news: If our hospital has just one patient a month stay in our facility instead of being shipped out, we've more than paid for our robot lease that month.

    Financing for telemedicine is very straightforward for a critical-access hospital because Medicare reimbursement is cost-based. We currently use the robot in our emergency department and in our rural health clinic. Even large hospitals that have outlying rural health clinics can take advantage of this cost-based reimbursement in justifying the purchase or lease of a robot.

    When we first contemplated the telemedicine option, I ran the idea by some experts at two of the leading healthcare audit firms. They took a close look at the numbers and agreed: Telemedicine will work well for you.

    Since acquiring our telemedicine robot, clinic volumes have increased a consistent 30% over the previous year—and our Medicare outpatient reimbursement has increased by 16% based on our last cost report.

    Our hospital is in a very remote location, 55 miles from the nearest town with a Wal-Mart store. The telemedicine robot has opened up many new opportunities for clinical affiliations, which has spurred increased interest from mid-level providers. In early 2013, we were losing money and on the verge of closing our doors. With telemedicine, we've revitalized many service lines and are a profitable hospital.

    Small hospitals across America are wondering whether they can afford a telemedicine robot. From our perspective, how can you afford not to make that investment?

    Bryan Coffey CEOHamilton County Hospital Syracuse, Kan.

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