New York City, Los Angeles, Seattle and other metropolitan areas have received the majority of media coverage concerning the toll COVID-19 is taking on our healthcare system. This coverage largely ignores the fact that the virus is even more devastating to vulnerable rural hospitals struggling to care for patients during the pandemic.
In this post, we will discuss the major challenges facing the country’s thousands of community hospitals, critical-access facilities, tribal hospitals, and other healthcare centers outside of major metro areas. We will then suggest a free solution that can help address these challenges and help rural hospitals quickly improve patient care during the crisis.
Pre-COVID challenges facing rural hospitals
There are a host of challenges facing rural hospitals, but three of the biggest center on staffing, data access, and financial resources.
Shortage of medical staff
Long before the outbreak, most health facilities outside of big cities areas were already understaffed. While 20% of the U.S. population lives outside of metropolitan areas, fewer than 12% of doctors serve this demographic. Worse, rural populations tend to be older and sicker, meaning they require more staff per patient.
The COVID-19 outbreak has only worsened the difficulty of providing quality care with such a large patient-to-staff ratio. The pandemic has in effect turned many of these smaller hospitals into emergency triage facilities – with limited ICU beds, ventilator equipment and specialized skilled staff – pushing many of the employees to their physical, emotional, and professional limits.
The need for quick access to mission-critical patient information
The Office of the National Coordinator for Health IT has researched hospitals’ adoption rates of electronic health records (EHR) technology through 2017 (the most current data available). The ONC found that although there has been widespread use of EHR technology among hospitals in general, rural facilities are among the least likely to use EHRs to inform their clinical practice and patient treatments.
There are several reasons rural hospitals have lagged behind their big-city counterparts in implementing digital-records technologies. In many cases, it is a budgetary issue: rural hospitals are typically smaller and located in underserved areas, and often do not have the funding for newer technologies.
In addition to these concerns, there has not been a widespread incentive for rural hospitals to adopt certified EHRs; many of those smaller hospitals that have EHRs are underutilizing the system or have not had the financial means to upgrade to certified versions. In some cases, the issue centers on the need for more IT training. Yet another negative consequence of under-staffing is that the medical and IT staff at smaller hospitals must take on multiple roles, limiting their time to learn how to use an EHR system, or to train new employees to do so.
As the CEO of a 14-bed rural facility said in an interview featured in EHRIntelligence, “When I got to the hospital, we had an EHR in a technical sense, but nobody was using it. It was a proverbial paper weight.”
Another major challenge is the ongoing funding gaps facing smaller and rural hospitals. This lack of funding might be the most serious hurdle, because it is a major contributor to the two problems discussed above.
As the COVID-19 outbreak worsened, many rural hospitals saw their financial conditions worsen as well, because their state governments prevented them from performing elective procedures, lab tests, and other revenue-generating services these hospitals depended on to fund their operations.
As many as 120 hospitals across the U.S. have indicated that they might have to close their doors for financial reasons at a time when society—particularly underserved rural areas—need these health facilities more than ever. At the time of this writing, the federal government is considering a hospital stimulus package to help bail out hospitals (both rural and urban) that have had to change their financial models to accommodate COVID-19 patients. However, it is still not clear if the funds will be sufficient or reach rural hospitals in time.
Consensus: Helping rural hospitals—and their patients—through the crisis
One immediate step that rural hospitals can take to address these challenges is to sign up for the Consensus Interoperability Platform—which offers free patient record query services during the COVID-19 crisis. Consensus is offered by J2 Global, the leader in cloud-faxing solution offering eFax Corporate in healthcare.
The full version of Consensus is a user-friendly cloud-based platform that connects hospitals, physician practices, payers, and other providers in the healthcare ecosystem, and enables them to share critical patient information when they need it most.
The Consensus interoperability platform can help streamline a hospital’s workflows and improve patient care in many ways: enabling direct secure messaging, patient information queries across many large-scale data exchange networks, and digital faxing, all through an inbox-like interface that will be familiar even to the least tech-savvy among your staff. During COVID-19, free on-demand patient record retrieval connected to the Carequality Network is a huge benefit for rural hospitals hit hard by the crisis.
Let’s review a couple of specific examples of how Consensus can help rural hospitals during the pandemic.
Problem: No longitudinal record
Imagine a patient enters into your emergency room. He/she has interacted with providers in another network or a non-integrated provider. While the patient may know the name of the provider, they may not know their full diagnoses history, their treatment plans, or their follow-up care. This gap can be concerning when the new provider needs to understand quickly any exacerbating conditions that can be critical when triaging or making a treatment decision.
Consensus solution: Patient records query
With Consensus, you can quickly conduct a broad patient query that searches the records of over 600,000 health systems and clinics. This patient record query service is free from Consensus during the COVID-19 crisis.
Problem: Delays in referring patients for follow-up care
If your hospital needs to prioritize COVID-19 patients due to limited beds and resources, it is important there is a seamless discharge for follow-up care. This transition of care can be to a skilled nursing facility, home health, rehab center or another hospital. The accepting facility will need to understand fully the patient’s condition and follow-up care to begin effective treatment. Moreover, it is critical that this transfer happen quickly because patients can decompensate or relapse once outside the supervision and care of medical professionals.
Completing these handoffs can be difficult and time consuming for hospitals, which often have to fax patient records manually to the follow-up care facility and then call to confirm the successful transmission of the paperwork.
Full version of Consensus solution: Including direct messaging and cloud fax
The full version of Consensus solves many of these interoperability challenges by allowing your short-staffed team to communicate critical patient information to the post-acute facility quickly and easily via secure direct message, as well as transmit patient records by digital fax from the same online portal. All without having to print any paper or wait by a fax machine to make sure the recipient’s fax machine received all pages.
These are just a few of the ways the Consensus interoperability platform can help your hospital improve transitions of care and interoperate with your community providers. Sign up for your Consensus account now, and start improving your hospital’s workflows and patient care.Jeff Solis