Technology is changing the way hospitals treat patients

The U.S. Senate last month passed the Expanding Capacity for Health Outcomes (ECHO) Act. This legislation is aimed to increase access to healthcare in rural areas by authorizing the U.S. Department of Health and Human Services to study the Project ECHO model.

The bill was introduced by Senators Orrin Hatch (R-Utah) and Brian Schatz (D-Hawaii), and passed 97-0. Though it doesn’t increase distribution of the ECHO model, the bill does prioritize the study of the model and paves the way for Health and Human Services to expand the model in the future.

“Our legislation improves medical services for all Americans by providing healthcare professionals in rural and underserved communities with access to a network of peers and specialists who can teach specialty care,” Hatch said in a statement before the bill was passed. “By connecting doctors and nurses with teams of experts, patients can receive the care they need, when they need it. And most importantly, patients won’t have to travel long distances to receive treatments; they can stay close to home and receive treatment from doctors they know and trust.”

According to a statement by the University of New Mexico, “the ECHO model does not actually ‘provide’ care to patients, instead it dramatically increases access to specialty treatment in rural and underserved areas by providing front-line clinicians with the knowledge and support they need to manage patients with complex conditions such as: hepatitis C, HIV, tuberculosis, chronic pain, endocrinology, behavioral health disorders, and many others. It does this by engaging clinicians in a continuous learning system and partnering them with specialist mentors at an academic medical center or hub.”

Specialists at academic medical centers can connect with primary care physicians via teleconferencing technologies. The model was developed by the University of New Mexico School of Medicine, and because there is no remote patient monitoring technology or direct patient-doctor communication through technology, it isn’t considered telemedicine.

Ron Gleason, CEO of Mineral Community Hospital said he wasn’t sure how this would impact their telemedicine services at the hospital. In additional to a telestroke, they also recently acquired a telepsychiatry unit.

“With the telestroke unit, in the emergency room a neurologist can remotely diagnose a stroke,” he said. “There is a network of doctors throughout the northwest that we can contact who can speak directly to the patient. By asking a series of questions and having patients do specific actions, they can determine whether it’s a stroke or something else. They can also recommend the proper medications if it is a stroke and then they can safely send the patient to Missoula for further treatment.”

Without the unit, a patient may be sent to Missoula for further treatment, sometimes by helicopter, which is expensive. Telemedicine can be especially beneficial to patients in rural areas, as well as for patients who are homebound and find it difficult to make the trip to a doctor. It also allows healthcare professionals in multiple locations to share information and discuss patient issues as if they were in the same place.

The telepsychiatry unit will provide psychiatric assessment and care through telecommunications. Gleason said they will have training on this unit after the first of the year.

Project ECHO was initially launched in 2003 by the University of New Mexico Health Sciences Center and has since grown both in the U.S. and internationally. More than a dozen centers in the U.S. operate teleECHO clinics and address more than 40 health conditions. There are also clinics running in 10 countries.

According to Hatch and Schatz, only about 10 percent of physicians practice in rural areas despite nearly one-fourth of the population living in these areas. Meanwhile, rural areas suffer higher rates of some chronic diseases and face challenges such as adequate transportation and connectivity with others.

It is also a challenge to recruit healthcare providers to work in rural and underserved areas and opportunities for professional development and support in these areas can be difficult. In November, Gleason said Mineral Community Hospital was suffering from a shortfall of employees including two full-time registered nurses and a full-time certified nurse assistant.

The healthcare industry is continuing to grow, according to the State of Montana 2016 Department of Labor and Industry Report, healthcare posted a growth of 1.5 percent in 2015, which is roughly 1,000 jobs over the year and the industry has added over 8,000 jobs since 2007.

But despite this growth, critical access hospitals like Mineral Community struggle to provide convenient, local access to quality care. Nationwide, 76 rural hospitals have closed since 2010 and 13 have closed in the past year.

Sen. Al Franken (D-Minn) is co-chair of the bipartisan Rural Health Caucus and said one of his top priorities is to “better equip our rural health providers with the tools they need to deliver the right kind of care to people in their communities.”

He said he fought for this bill because it seeks to connect local doctors with specialty care doctors to better address patients’ medical needs. Franken has been a long-standing advocate for finding solutions for the unique health care challenges facing rural communities, including the expansion of telemedicine. He said that rural communities often lack specialty doctors for mental illness, addiction, diabetes, and pregnancy and telemedicine can help fill those gaps.

“We’re now one step closer to supporting new ways to train health providers and deliver health care,” Sen. Schatz said in a statement. “Technology is changing the way medical professionals connect with each other and their patients. Our bill capitalizes on this technology to give health professionals in hard-to-reach areas the specialized training they need and help them reach more patients.”