Rural critical access hospitals benefit from telemedicine in EDs

The use of telemedicine in emergency departments operated by rural critical access hospitals is not only saving healthcare costs for these facilities but is helping them to recruit and retain physicians.

That’s the finding of a new study from the University of Iowa published in the December issue of the journal Health Affairs.

“In a sample of 19 hospitals, coverage schedules in 2016 showed that seven had begun the use of tele-ED physician backup for advanced practice providers, decreasing local physician coverage in their EDs,” state the authors. “These seven hospitals tended to have decreasing ED staffing costs, while the hospitals not applying this policy showed continually increasing staffing costs over time. Telemedicine also provided other benefits, such as improved physician recruitment and retention.”

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Specifically, rural hospitals that moved to tele-emergency services as backup saved an average of $117,000 annually in provider compensation costs, while hospitals in the same network that continued to staff their ED with on-site or on-call physicians saw an average increase of $138,000 in annual provider compensation costs.

In addition, hospitals in the study that switched to telemedicine services found it easier to recruit new doctors because they could offer a better work-life balance, since physicians did not have to cover an ED shift.

Seven of the hospitals in the study took advantage of a 2013 Medicare rule clarification.

“A 2013 memorandum from the Centers for Medicare and Medicaid Services clarified that a telemedicine physician could fulfill the regulatory requirements for physician backup when advanced practice providers were at telemedicine-equipped critical access hospital EDs but local physicians were not,” point out the study’s authors.

Also See: CMS plan to improve rural care includes greater use of IT

With a continuing shortage of physicians to cover emergency departments in rural hospitals, increasing the use of tele-emergency services could be a viable solution for these healthcare organizations in addressing staffing shortfalls, according the authors.

“The study finds that expanding options for provider coverage to include telemedicine in some rural emergency departments has noticeable benefits,” says co-author Marcia Ward, professor of health management and policy in the UI College of Public Health and director of the Center for Health Policy and Research. “This supports the viability of critical access hospitals at risk of closing and leaving their communities without local emergency care.”

“In the future, more critical access hospitals will likely use telemedicine to provide physician backup for advanced practice providers staffing the ED,” the study concludes.

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