Session 9

Topic:  Rural Medicine – Telemedicine and other issues

Convenor: Linda Bowlby

Note Taker: Becky King

Participants:

Kathleen Roberts, Mike Mitchem, Donavon Beckett, Elmer Nagye, Joe McFarlane

Key themes, outstanding questions, observations:

KEY THEMES:

v     Ritchie is in beginning phases of looking at telemedicine as a long-term project

v     Seems to make sense to use because of rural nature of state/nature of visits –  can be used for trauma and follow-up visits – looked at program in Tucson, Okalahoma

v     Doesn’t cut out local doctor, but adds expertise

Group  discussed several areas of the state that have successfully used telehealth:

v     Tug River has received a grant for telemedicine – it is working for adolescent mental health at the school-based health center there

Mental health is a big issue/need across the state (drug overdose/suicides

v     Telehealth has been used at Mount Olive corrections and connected to Morgantown docs

v     Trauma does not work as well for telehealth – discussed an example – there is a place for it, especially if there is no adequate ambulance service

v     Biggest assets of telehealth: saves patients travel time and money

Other strategies for improving access to rural health:

v     Think about bringing specialists once a month to an area (Larry J. Harless Community Center; Anstead has been successful in bringing in a gyn, surgeon.  Needs an endocrinologist now

v     Need to explore being a designated site for AHEC/RHEP to attract residents:

Connect to bring rural medicine students and residents to train/practice at facilities – shift dynamic to outreach – 80% will stay in an area where they train – also results in building an economic base – creating an industry from another industry – example- Pikeville KY grew hospital, medical school, residency program has grown..WV Osteopath school has grown and is developing post-doctoral sites across the states

v     SCHIP expansion and outreach is an important program – has the potential to cover a lot more children

v     Travel and taking time off of work is a big issue for specialty care

v     Look at PEIA programs such as weight management – free face-to-face program

v     Marshall University has great grants to apply for

v     Look at home health organizations for possible diabetic educators

v     Health Fairs are also successful in rural areas

v     Rural counties could develop regional networks  offer telemedicine/remote emergency rooms

Additional Impacts/Themes:

v     Community has to learn to trust outside specialist provider

v     Word of mouth/some marketing works to let the community know that services are available – it doesn’t take long to build a patient base 

v     Biggest problem with telemedicine – how do you compensate the doctor on the other end/some physicians are open to having additional expertise/others are not

v     Need to find specialists on the other end (MU, Osteopathic school, local hospitals, clinics)

What can BP do to meet this challenge?  Funding for costs such as equipment, identifying where telehealth is working in rural counties, identifying where specialists are located, how to finance

Recommendations to Move This Forward:

v     see firsthand what other communities are doing/lessons learned

v      what insurance providers will cover local and specialist costs/telemedicine

v      find out what hospitals have worked this out

v     find out what services local doctors already have set up, where are they sending people for specialty care

v     approach large employers in the county to see how they can help

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