Telemedicine helps sustain rural health care

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The Arizona Telemedicine Program Warren Street Clinic is located at the University of Arizona’s Arizona Health Sciences Center. The left monitor shows the patient, while the right monitor shows the patient’s information. (Photograph by Joanna Daya)

Access to health care in rural and underserved communities could be improved as telemedicine progresses and advances.

At the same time, officials say, using video technology to reach patients could help rural hospitals in Arizona and around the world stay afloat as they combat financial woes and doctor shortages.

“There has been 58 rural hospitals that closed in this country in the last five years,” said Dr. Daniel J. Derksen, director of the University of Arizona’s Center for Rural Health. “Unfortunately, one of them was here in Douglas.”

Cochise Regional Hospital shut its doors in July 2015, leaving many residents of Douglas no choice but to drive more than 20 miles to the nearest hospital, Bisbee’s Copper Queen Community Hospital.

Other shuttered facilities in Arizona included Kingman’s Hualapai Mountain Medical Center in 2011 and Florence Community Healthcare in Florence in 2012.

Hospital closures in rural areas are often due to a combination of financial problems and lack of health professionals, providers and services.

“Rural hospitals and clinics in general tend to have more trouble recruiting and retaining health providers of various types,” Derksen said. “We don’t have enough people getting trained in rural areas.”

However, with telemedicine, rural hospitals can expand the services they offer without having to worry about retaining physicians, while also keeping costs low.

Arizona Telemedicine Program's Warren Street Clinic
Arizona Telemedicine Program’s Warren Street Clinic also serves as a training facility for physicians. (Photograph by Joanna Daya)

“Sometimes you can provide high quality accessible services through these new technologies, and that’s a way you can address unmet needs in rural communities that really couldn’t support maybe a full-time person,” Derksen said. “[Telemedicine] can certainly augment the services that you offer and also enhance your finances if you’re offering things that people want and need.”

Telemedicine is the “practice of medicine at a distance, usually using video technologies and other IT technologies,” according to Dr. Ronald S. Weinstein, founding director of the Arizona Telemedicine Program at the University of Arizona.

For more than 20 years, the Arizona Telemedicine Program has been providing “telemedicine services, distance learning, informatics training, and telemedicine technology assessment capabilities to communities throughout Arizona,” according to its website.

“We have these huge telecommunication lines that still do connect and provide a backbone,” said Janet Major, associate director of facilities for the Arizona Telemedicine Program. “Now, we’re a resource center more than anything.”

Through telemedicine, residents of underserved communities can access health care without having to drive to their closest city for medical attention.

According to a Centers for Disease Control and Prevention 2011 survey, almost 80 percent of adults visited the emergency room only because of their lack of access to a primary care provider, and 48 percent of adults living outside metropolitan areas had to find another place to seek medical attention because their doctor’s office was not open.

“So many of the patients leave the community to come to the larger cities for their services,” Weinstein said. “Telemedicine is a way of reducing distance, to bring specialty medical services to underserved populations.”

Telemedicine also provides patients with a cheaper alternative to health care. A 2014 assessment found that with the estimated cost of one telemedicine visit averaging from $40 to $50 compared to the $136 to $176 average cost for in-person visits.

Copper Queen Community Hospital
Copper Queen Community Hospital is located in Bisbee, Arizona. It offers various telemedicine services. (Photograph by Joanna Daya)

Copper Queen Community Hospital is one of the rural hospitals in Southern Arizona that has embraced telemedicine.

Copper Queen offers programs such as teleburn, telepediatrics, telecardiology, telepulmonology, telestroke and teleradiology. These programs allow physicians at Copper Queen to work with physicians at other hospitals to “provide patients with the best possible care.”

“[Copper Queen has] made, certainly, one of the most impressive efforts to bring services into the Bisbee hospital, so patients wouldn’t have to leave,” Weinstein said.

Studies have shown that telemedicine provides improved quality of care, and that “there is no difference in the ability of the provider to obtain clinical information, make an accurate diagnosis and develop a treatment plan that produce the same desired clinical outcomes as compared to in-person care when used appropriately,” according to the American Telemedicine Association.

Patients who have sought medical assistance through telemedicine have mostly been satisfied and have responded well to telemedicine. Despite not being in the same room physically with a doctor, Major said many patients feel that they are getting a higher-quality experience through telemedicine.

“It should be business as usual,” Major said. “It shouldn’t be anything cruel and unusual. A doctor, rather than going from room to room and knocking on the door, is looking up and talking to you on TV.”

Joanna Daya is a reporter for Arizona Sonora News, a service from the School of Journalism with the University of Arizona. Contact her at jofran15@email.arizona.edu.

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