Sidney Regional Medical Center is a critical access hospital in Sidney, Nebraska, that serves a seven-county area in the western Nebraska panhandle. Like so many rural hospitals, Sidney struggled with connectivity issues.
The hospital provides a wide array of services, including those not traditionally found in a rural community. This includes access to acute care, critical care, 24-hour emergency room, physicians’ clinic, walk-in clinic, surgical services, home health and hospice, extended care, assisted living, and more.
The hospital currently employs more than 390 employees. The medical staff includes four family practice physicians, two general surgeons, a urologist, a hospitalist, 10 certified physician assistants and nearly 20 visiting providers who specialize in areas such as ear, nose and throat, cardiology, gastroenterology, orthopedic surgery, pain management, and podiatry.
“Between multiple sites, staff and departments, we need stable and reliable internet to maintain communications, exchange critical health records and deliver quality care to our patients,” said Jennifer Brockhaus, CIO at Sidney Regional Medical Center. “Unfortunately, the connectivity offered by our previous internet provider was very inconsistent, so we often suffered from downtimes and slow speeds that hindered our operations.”
Further, the hospital was seeing growing demand for having primary care providers available in its clinics in smaller towns like Chappell and Potter that are up to 30 miles away. However, the costs to have local providers in these locations would have been very high. Such access to healthcare and broadband internet is not only a challenge for these communities, but also for much of rural America.
About three years ago, the hospital decided to make the switch to Great Plains Communications, the largest independent telecommunications provider in the state of Nebraska. The company installed a dedicated fiber connection between the provider organization’s locations, as well as its radiology organization.
“With redundant fiber routes for direct internet access in and out of Sidney, we have virtually eliminated downtime,” Brockhaus said. “This has helped improve our overall patient and employee satisfaction.”
By moving to dedicated fiber broadband, the hospital has drastically increased its internet speeds so providers and staff at all locations can work more efficiently. With direct fiber connection between each site, staff can send and receive patient records faster than ever. A prime example of this is radiology reports. The radiologists have commented repeatedly how quickly images get to them since the organization moved to fiber.
“Improved internet connection has also enabled us to offer an online patient portal for a better and easier experience,” she explained. “As part of a national initiative for patients and providers to use electronic health records, our patient portal ensures that all medical records are secure and accessible at any time. The portal gives patients the ability to schedule appointments, pre-register, pay for services, see tests results, and send or receive communication from their healthcare provider.”
Network infrastructure and internet offerings vary by geographic region. Healthcare organizations can consult their local utility companies and internet service providers for options. As for telehealth, there are many vendors on the market today offering telemedicine technology, including American Well, Avizia, GlobalMed, MDLive, Novotalk, SnapMD, Teladoc, TeleHealth Services and Tellus.
MEETING THE CHALLENGE
With faster, reliable internet routed across all locations, Sidney Regional Medical has been able to enhance its healthcare services through telemedicine. Patients in the smaller, distant towns of Chappell and Potter can go to a local clinic and ‘see’ a provider in the main walk-in clinic in Sidney via video conference.
“Telemedicine gives those in these smaller communities a way to see a provider and not have to drive dozens of miles for even the most minor cases like sinus infections, pink eye, sore throat, cold or flu,” she said.
The provider organization uses Lifesize as the video conferencing equipment for its telemedicine services. It is HIPAA-compliant and works efficiently, Brockhaus said.
“A receptionist at each site helps the patient use the equipment and connect with their provider,” she explained. ”On the provider’s side, they have dual monitors so they can see the patient via video conference on one screen and have their EHR pulled up on the other. We currently use Evident as our EHR vendor, but plan to move to Epic in 2020. If a patient needs any medications, the provider can even write up a prescription electronically for them to pick up at a local location.”
With its previous internet vendor, the provider organization did not go a week without some form of downtime. But since switching to a dedicated fiber connection, the organization has had only two minor instances of connectivity issues – a huge improvement from the internet troubles before, Brockhaus said.
“When it comes to telemedicine, our patients are still getting used to the idea,” she added. “Many still like to drive to a clinic and physically see a doctor. So it is a growing practice in these rural communities. But telemedicine at least gives them an option rather than driving up to 30 miles for care. We are continuing to advertise our telemedicine services in these towns, so we expect growth ahead.”
ADVICE FOR OTHERS
“For any other healthcare provider considering updating their internet with dedicated fiber or looking to add telemedicine, I would say start small,” Brockhaus advised. “By focusing on small, iterative steps, you have the opportunity to work out any issues before moving too far ahead.”
For instance, the next step that Sidney Regional Medical is looking at is telemedicine in the home.
“This will allow patients to do their appointments from the comfort of home using their own smartphones, tablets or laptops,” she explained. “It will take some time for people to get used to this concept. That is why we are starting slowly with offering telemedicine in the communities, with the intention to broaden our horizons in the future.”