Building a Telemedicine Program to Create a Sustainable Care Delivery Model for a Rural Hospital at Risk for Closure

Area of Science:

• Healthcare Management
• Telemedicine
• Rural Health

Background:

• Rural hospitals face significant challenges including high fixed costs, low patient volumes, and outmigration.
• Hospital closures are a national concern, threatening access to care in rural communities.
• Innovative solutions are needed to ensure the sustainability of rural healthcare facilities.

Purpose of the Study:

• To describe an innovative telemedicine partnership between a rural hospital and a tertiary care medical center.
• To present a sustainable care delivery model for rural hospitals.
• To evaluate the impact of telemedicine on patient care and hospital outcomes.

Main Methods:

• A single-center descriptive case study was conducted.
• The study involved a 32-bed not-for-profit rural community hospital and a comprehensive medical center.
• A strategy and logic model was used to analyze the telemedicine program's development and implementation.

Main Results:

• Yearly admissions at the rural hospital increased from 442 to 965 between fiscal years 2019 and 2022.
• Inpatient transfers decreased by 20%, and 30-day readmissions reduced by 35%.
• The hospital managed a more complex patient population, indicated by an increased case-mix index, with no rise in outmigration.

Conclusions:

• Telemedicine partnerships can create sustainable care delivery models for rural hospitals.
• This innovative approach enhances rural hospital survivability amidst national closure trends.
• Collaborative telemedicine models leverage tertiary care expertise to support rural communities.