Before the COVID-19 pandemic struck, Greene County General Hospital in Linton, Indiana, faced challenges in providing access to care because the area has transportation barriers.

THE PROBLEM

Greene County spans 546 miles, and has a population of about 30,000. Even though the healthcare organization offers four rural health clinics throughout the county, patients still were having difficulties finding transportation to their appointments. Patients may live miles away from the nearest clinic and may not have reliable transportation or resources. The county has few transportation resources available.

When COVID-19 flared up, Greene County General faced a whole new set of challenges. It needed to provide care for patients while limiting their exposure to the virus. It then began its telehealth program using Agnes software, but recently switched to Tyto hardware and software.

PROPOSAL

“To give a bit of background, in the fall of 2019, we began implementing telehealth in our schools,” said Brenda Reetz, CEO of Greene County General Hospital. “We started with one school and quickly expanded. When implementing telehealth, we hoped it would connect Greene County students to healthcare without parents needing to arrange transportation or leave work.”

It offered access to care that many students otherwise would not have. After COVID-19, Greene County General hoped it would limit patients’ exposure to the virus while still allowing patients to take care of their health needs.

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MEETING THE CHALLENGE

Before COVID, telehealth had expanded access to healthcare in the schools. Within two years of developing a telehealth service, every school in Greene County (and one school outside the county) had telehealth available.

“Since COVID, we looked at our telehealth model and quickly moved the equipment from the schools, since schools had closed, to our clinics, and offered telehealth to all of our patients,” Reetz explained. “It allowed us to quickly and effectively respond to our community’s needs during a pandemic.”

Overall, implementing telehealth has helped Greene County General meet both its county’s transportation and exposure challenges. The availability of interactive telehealth equipment in schools allows students to visit with a provider while at school, without a parent having to leave work to take the child to an appointment. Some children can finish the school day if the provider believes it’s appropriate.

Prescriptions for medications are sent to a pharmacy of the parents’ choice, and many of the tests the provider orders can be performed at school.

As for the community, the ability to virtually visit with a provider helps facilities “screen” patients who may be more at risk and need to stay home or who are symptomatic and need to quarantine. It also allows providers to continue routine care and connect to their patients. Continuity of care is very important to the overall health of patients, Reetz noted.

RESULTS

Initially, Greene County General believed that many of its patients might be resistant to using the new technology. However, patient satisfaction surveys and patient comments show that most patients that use the telehealth platform for visits appreciate the convenience and find it easy to use, said Racheall Langacher, director of rural health clinics at Greene County General Hospital.

“Our program grew rapidly,” Langacher said. “In the beginning of the 2018-2019 school year, we had 89 students from one school enrolled in telehealth services. By the end of that school year, we had four schools enrolled. In 2019, our providers saw 49 students. As of today, we have 534 students from seven schools enrolled.”

The healthcare organization is in the process of adding two additional schools. In 2020, providers saw 20 students via telehealth. With COVID-19 closing the schools, that is not a fair assessment of utilization, Langacher said.

“We expect our student numbers to climb,” she noted. “During the COVID-19 pandemic, telehealth has allowed us to see patients that were fearful of coming into a medical office to be seen by a provider. They were able to stay home, stay safe and receive the care they needed. Since implementing telehealth in our clinics and opening the service to all patients, our providers have treated 989 patients via telehealth from March 18, 2020, through July 14, 2020.”

USING FCC FUNDS

Earlier this year, Greene County General was awarded $60,480 by the FCC to expand its mobile telehealth capacity to ensure continued care to its patients, including its senior patient population, who have been displaced by the emergency COVID-19 response within its current facilities.

“Our overarching goal is to expand our region’s access to care and provide healthcare while limiting the exposure of COVID-19 to our community,” Reetz explained. “This includes safely resuming preventative and non-emergent care while preserving PPE and keeping our staff safe and healthy. Our community and subsequent patients include a high volume of at-risk vulnerable residents.”

Currently, all patients are screened at the hospital, clinics and facilities. Expanding telehealth provides the opportunity to screen patients even more effectively and provide care to those who are unable to leave their homes, she said.

“With the FCC funds, we will purchase 28 additional Tyto telehealth units/software,” she concluded. “This will provide all our nursing homes, senior care facilities, clinical hospital departments, clinics, employee health and EMS ambulance service the ability to provide telehealth services. As for EMS capabilities, we are partnering with them to provide post-care follow-up telehealth visits.”

Twitter: @SiwickiHealthIT
Email the writer: bill.siwicki@himss.org
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