Today’s hospitals are under pressure. As community hubs of healthcare, they are tasked with delivering expert medical care across emergency departments, outpatient practices, surgical suites, labs, radiology departments, intensive care units, and more.
That in itself is a tall order. But consider that in addition to this, the coronavirus pandemic forced them to face an onslaught of emergency cases far beyond an imaginable forecast. And although they quickly rose to the occasion, it's important to note the other expectations they are asked to meet including:
- Provide an exceptional patient experience
- Lower healthcare costs
- Meet accountable care and risk contracts
- Deal with changing reimbursement policies
- Improve community and population health
- Avoid Medicare readmission penalties
- Prevent provider burnout in the face of a provider shortage
Now consider how much of a challenge that is for small hospitals – many of which are closing or have limited resources to fully serve the communities they treat.
The Gradual Vanishing of Small Hospitals
A podcast from the Wharton School recently addressed the closure of Philadelphia’s Hahnemann University Hospital and the spreading extinction of rural hospitals. According to a Chartis Center for Rural Health study, 120 have shuttered since 2010. The podcast noted that many big-city hospitals have consolidated to absorb financial losses and mitigate their operational costs, which has had a negative impact on small hospitals.
Drexel University’s Robert Field, a law and health management professor, and Wharton lecturer observed that major hospital systems are not only growing in size but growing more sophisticated. “They’re adding high-tech procedures and equipment. They’re now onto gene therapy and these futuristic kinds of treatments,” he said. “But the lower-tier hospitals, which is what Hahnemann has been, or even the mid-tier hospitals have not been able to survive on their own. We’re seeing everything drawn to the major centers, which is a particular problem in rural areas, where those centers might be 50 miles away.”
The closure of a small hospital will have inevitable consequences for its surrounding towns. In addition to ending the employment of hundreds of local residents, from nurses to cafeteria staff, the closure will force patients to travel further for basic care. This can have a dire impact in medical emergencies, especially for patients having a stroke or heart attack in a town two hours from the nearest hospital.
Many small hospitals have fought to stay open and continue providing services to their communities. Yet many still face financial struggles and provider burnout, which can also impact patient care.
One solution: virtual care. Not only can virtual care delivery help small hospitals compete and survive, but they can also use virtual platforms to:
- Offer a range of care. Services can include primary and specialty care, e-ICUs, presurgical consultations, postsurgical transfers, remote patient monitoring, urgent care, pediatrics and chronic care management.
- Manage capacity. Hospitals can better balance patient needs and provider workloads by using off-site clinicians as needed.
- Follow up with patients after discharge. Remote patient monitoring can spark interventions and prevent readmissions for conditions like heart failure and chronic obstructive pulmonary disease.
- Support continuity of care. Virtual health platforms can connect doctors, pharmacies, payers, clinics and nursing facilities to help them exchange medication lists, discharge plans and keep them updated on the patient’s medical status.
- Reach more patients in the community. Through programs such as providing medical care to inmates at local prisons, hospitals can provide more services without capital expenditure investments.
- Involve patient families in daily hospital rounds. Virtual visits can keep patients’ relatives connected to their loved ones’ care even when they’re across the country.
- Prevent crowded emergency department waiting rooms. Telehealth can route some patients to a radiologist, laboratory or primary care, which helps patients with true medical emergencies receive faster care.
- Connect patients to specialists and advanced medical expertise. For instance, a telestroke program can help a hospital without staff neurologists.
- Attract Millennial and Generation Z patients with digital conveniences. Now comprising all adult patients under 40, this demographic often prefers virtual visits to traditional office.
- Recruit, relieve and retain providers. Physician burnout is reaching epic levels - but telemedicine can help them see patients from home, keep flexible hours and earn additional revenue through evening and weekend appointments.
- Increase downstream referral revenue. Providers can refer patients to in-network providers for radiology, laboratory, primary care and other services.
- Eliminate patient leakage. Instead of losing patients to high-profile specialists or hospitals, small hospitals can virtually connect patients to their preferred providers.
Keeping Expert Care in Every Community
Retaining advanced medical care in rural communities and small towns is vital. The National Rural Health Association reports there are only 30 specialists per 100,000 people in rural communities, compared to 263 specialists per 100,000 urban residents, yet the rates for the five leading causes of death in the U.S. – heart disease, cancer, unintentional injury, chronic lower respiratory disease, and stroke—are higher in rural communities. Without the preventive screenings and ongoing care facilitated by a local hospital, these patients can face dire consequences. Telemedicine can restore a culture of care even in remote communities and help their populations live healthier lives.