"With the growing usage of PCs and the Internet by providers and patients, programmes are increasingly being developed to support the needs of rural health providers, remote diagnosis, care delivery, communication, and education", according to Fran Turisco, report co-author, First Consulting Group.
Case studies examined technology uses in rural settings in the United States and internationally. They include: a Department of Veterans Affairs Medical Center in Iron Mountain, Michigan, that combines remote diagnostic services with real time remote specialist visits in Milwaukee and Chicago; a medical centre in Spokane, Washington, that built a technology infrastructure which supports two dozen hospitals serving small farming communities; and a radiology services provider in Australia that offers night coverage for rural hospitals and providers in the United States.
Providing access to specialists is one of the most successful uses of technology to support rural health delivery. With up to 90 percent of speciality physicians practising in urban areas, diagnostic specialists are in short supply in rural areas. A case in point, Robert Webber, M.D., a primary care physician in Watsonville, California, uses a clinical messaging system for physician-to-physician e-mail and has developed a relationship with rheumatology specialists in Santa Cruz. In another case, patient monitoring and video tele-conferencing technology allows specialists at UC Davis Medical Center to provide paediatric intensivist services for Mercy Medical Center in Redding.
The report finds the common denominator in successful rural technology programmes is collaboration among individual providers and institutional players including rural health associations, vendors, government agencies, federal and state associations, advocacy groups, hospitals, and existing telemedicine programmes.
According to Thomas Lee, M.D., M.B.A., senior programme officer at CHCF, "California has a number of programmes that are already up and running to help bridge providers to partners for health technology solutions. One of the country's largest is the Center for Health and Technology (CHT) at UC Davis. The centre provides a variety of education, information access, and medical care services".
Fran Turisco noted: "The availability of funding sources, changes in regulations for services reimbursement, and other payment options have opened the doors for rural organisations and providers ready to use technology." The report provides sources that help fund and maintain technology-based programmes, including examples of type of projects funded and an appendix of potential funding sources.
Costs for technology tools have been decreasing. "Tools are becoming more powerful, smaller, and less expensive", stated Dr. Lee. "Workstations that cost $5000 five years ago are now less than $1000. Advanced video tele-conferencing workstations that filled a room and cost $80.000 per unit several years back now have a price tag around $40.000 and are becoming small enough to be truly portable."
With dropping technology costs, more user-friendly IT tools and available innovative financing, rural health care providers are increasingly able to adopt IT solutions that were not possible even a few years ago. Couple those factors with newly emerging health care collaboratives that encourage technology transfer and sharing, and there has never been a more promising time for adoption of IT solutions in rural health care.
The California HealthCare Foundation is an independent philanthropy committed to improving California's health care delivery and financing systems. The iHealth Reports series focuses on emerging technology trends and developments and related policy and regulatory issues. Copies of this, and other publications, can be obtained by visiting the California HealthCare Foundation's Web site. "Rural Health Care Delivery: Connecting Communities Through Technology" can also be found on-line.