ER telemedicine defines growing rural-urban health gap

Dr. Kelly Rhone with a map of hospitals using Avera eCare. (Photo by Michael S. Williamson, The Washington Post)

"If anything defines the growing health gap between rural and urban America, it’s the rise of emergency telemedicine in the poorest, sickest, and most remote parts of the country, where the choice is increasingly to have a doctor on screen or no doctor at all," Eli Saslow reports for The Washington Post.

Avera eCare Services is a major telemedicine provider; the Sioux Falls, S.D., office "provides remote emergency care for 179 hospitals across 30 states. Physicians for Avera eCare work out of high-tech cubicles instead of exam rooms," Saslow reports. "They wear scrubs to look the part of traditional doctors on camera, even though they never directly see or touch their patients. They respond to more than 15,000 emergencies each year by using remote-controlled cameras and computer screens at what has become rural America’s busiest emergency room, which is in fact a virtual ER located in a suburban industrial park."

Telemedicine is one answer to a growing problem. The number of rural ER patients has increased by 60 percent in the past decade, but rural doctors and hospitals have declined by up to 15%, and many hospitals and standalone ERs are on the brink of bankruptcy, Saslow reports. Access to telemedicine actually helps retain rural doctors, too, since it gives them more support and time off to recharge.

Hooking up to telemedicine can be expensive, though. The standard subscription rate for Avera is about $70,000 a year, and the hospital must be outfitted with fiber-optic cables, cameras, and microphones. Beyond that, the hospital must have (and pay for) broadband access, Saslow reports.