Health disparities have the potential to negatively impact rural Americans much more than urban Americans. No doubt, rural healthcare currently is facing many challenges, such as lack of bed availability – even as COVID-19 decreases.
Dr. Richard Watson is co-founder of Motient, a health IT vendor that equips health systems, accountable care organizations and individual facilities with tools and data designed to help ensure quality in medical transports.
Healthcare IT News interviewed Watson to discuss the state of rural healthcare today, the role technology can play in preserving rural healthcare, how CIOs can help ensure sustainable quality in medical transports, and how having the right tools and data when it comes to patient transport can benefit a hospital or health system in terms of patient outcomes, provider satisfaction and overall costs.
Q. What is happening with rural healthcare, and specifically bed availability in rural healthcare?
A. We quickly moved from a pandemic crisis to a staffing crisis. This is not something new, and a lot of rural facilities were already dealing with staffing issues prior to the pandemic.
The first round of COVID-19 tested the system, while the second round crippled it. The rise of agency nursing and the mobility of nurses lured to large paychecks, as well as attrition in rural areas, has really hurt hospitals’ ability to staff.
The overall problem for rural hospitals right now is sustainability. We have many hospitals that are at a critical crossroads in deciding what they will be in the coming 10 to 20 years.
They serve a decreasing population that still desires to have an acute inpatient facility. What will the hospital of 2030 look like? Helping facilities understand their true purpose and their potential for revenue is directly dependent on the data they have around their patient population.
Q. What do you see with these trends in the next year?
A. There’s no doubt that 2022 will be a moment to come up for air. As the economics of rural healthcare change, hospitals’ analysis (or lack thereof) regarding how they fit into their ecosystem will determine how rural healthcare is able to move forward.
The ability to do more with what you have, and the flexibility to care for those in your community, are core hallmarks of rural healthcare. I think facilities will have to capitalize on these strengths in order to come out in a positive way from the pandemic.
Q. How can technology play a role in preserving healthcare in rural America?
A. A lot has been made of the role technology can play in rural healthcare. I think there are many solutions that get passed on to rural facilities that end up becoming onerous for those who are using them. More time is spent maintaining the systems and educating the users than anything else; there is little of benefit or value.
In the coming decade, direct access to information, the ability to do telehealth, and the tools to enable data analysis around the personality of rural facilities will be important. Facilities need to become very focused on who they are and what their mission is.
By using technology to understand the health patterns of their communities and focusing on providing services that keep people close to home for the majority of their care, healthcare organizations can find the answer to quality and sustainability questions.
I do think we have to look at reimbursement in rural areas and understand that much of what comes down the pike, with regard to quality metrics and edicts, does not fit well with the reality of rural health. All of the geographic and demographic offsets will do little to counterbalance that. It seems the current reimbursement schema allows rural facilities to barely keep their heads above water.
Q. You suggest it’s a priority for healthcare provider organization CIOs to get the data required to ensure sustainable quality in medical transports. Why? And how can they do that?
A. This is a question I think is overlooked by most smaller facilities. We talk a lot about population health and the ability to control the behavior of people with chronic disease to support optimal outcomes. It’s a lofty goal and certainly something we need to strive for, but even more important is a facility’s understanding of patient movement throughout their ecosystem.
If a facility can really get a grasp on who is going out their door and what is the make-up of the services that patients are being transferred for, they can begin to identify more avenues for sustainability and enhanced quality. They can figure out how those patients can be returned to their home base for care, and begin providing the services people need closer to home.
The ability to understand how patients move in the system is the key to transforming the system. We spend a lot of time trying to save bandages and use the right antibiotic, but in reality, these measures are worth just nickels and dimes compared to the dollars that move when patients are transferred to the wrong destination and the wrong level of care.
Most important, patient movement and financial sustainability are directly tied to quality. We can waste a lot of dollars trying to create quality systems and lose the ability to be sustainable.
Q. How can having the right tools and data when it comes to patient transport benefit a hospital or health system when it comes to patient outcomes, provider satisfaction and overall costs?
A. Visibility is the most important thing in this area. Most facilities will do the right thing if they have the right information in the right time frame. So often, the information is there, but it’s only available months after the fact. Then it becomes just another line on a spreadsheet that never gets used in any significant manner.
The ability to know in real time how patients are moving and where they are moving to, and for what reason, allows hospitals to take action in relation to those transfers. Many times, facilities are sending cases out the door that they really could develop a service line for internally.
Larger systems often will have acquired smaller facilities or systems that have specialized services within that ecosystem. It is not uncommon for these large systems to have patients going out of network for services that could be provided in network, if only there was real-time visibility into that activity.
Most providers will react positively to change if they’re given the chance to understand the dynamics of how that change will positively impact the facility. I think this level of control gives everyone a better feeling about the job they’re doing and the facility’s ability to provide the best care for the patient.
Giving providers permission to keep patients they might feel pressured to send to another location – and allowing them to feel justified in using a certain level of resource, whether that be mode of transport or a specialty hospital – is an important prerequisite for providers making good decisions.
When sending facilities, receiving facilities and transport agencies all are seeing the same information and the same data, good things can happen. I genuinely believe that given the right information, these groups will choose to do what’s best for the patient.