Electronic emergency services at rural hospitals help patients, reduce transfers, save money

Electronic emergency services are bridging the gap between understaffed rural hospitals and specialist-saturated urban centers. One example is St. Michael's Hospital Avera, a 25-bed critical access hospital in Tyndall, S.D. It is one of about 60 rural hospitals that has signed up with Avera e-Emergency Services, a hospital-based telemedicine emergency support service.

From its operations hub in Sioux Falls, Avera emergency physicians like Dr. Brian Skow, right, and emergency-trained nurses help rural providers 24 hours a day, The Rural Assistance Center's Candi Helseth reports. They do everything from offer treatment advice to initiate diagnostic testing. "I didn't have any idea this existed," patient Leonard Hajek said. "The nurse pushed a button and just like that this doctor is on a TV screen talking to me."

The technology seems to be paying big dividends in patient care. It has reduced patient length of stay, patient transfers to tertiary-care hospitals and has saved money.

In Northern California, Sutter Health, the first health-care organization to connect a rural hospital to an electronic ICU, has likewise seen improvements in patient outcomes. "Deaths related to sepsis have decreased 28 percent system-wide and ICU patients' lengths of stay have decreased by 15 percent from 2007 to 2010," Helseth reports.

Rural physicians also appreciate the extra help and having access to a second opinion. "It means there is another doctor instantly available who I can consult and who is going to be helping if I need it. It makes me feel like I'm not as isolated practicing here," said Dr. Jill Kruse, family medicine physician at St. Michael's Hospital.

"Medicine isn't meant to be practiced in isolation," said Deanna Larson, vice president of Quality Initiatives and eCARE Services. "There are physicians who want to practice in rural areas but all of a sudden, they're everything to everyone and it's impossible to know every facet of medicine. They need access to peers for support. They also need time to sleep and see their families." (Read more)