Is It Time For Telehealth in Your Rural Hospital?: A Needs Assessment

Healthcare shortages in rural areas are problematic, with a physician to patient ratio of 1 physician per 2,513 patients. The purpose of this needs assessment was to determine the access and demand for specialized providers in one rural level IV critical access hospital in Utah. This project assessed 1) all patients over the age of 18 who presented to the emergency department, medical-surgical unit, labor and delivery floor, and surgical center; 2) permanent and visiting physicians, nurse practitioners, and physician assistants. After completing individual chart reviews of each patient seen at the facility, their final diagnosis and co-morbidities were compared to available resources including physicians, nurse practitioners, physician assistants, and telehealth services currently available. Over a selected 3 month period, 1753 patients were seen at this hospital, with the most common diagnoses being cardiovascular, gastrointestinal, or respiratory in nature. There were 19 permanent providers, 9 visiting specialties, and 7 telehealth consultation services available to be utilized for patient care. It was found that of the patients seen, 16.9% were transferred, 14.4% were admitted, and 68.7% were successfully treated and discharged. An executive summary with recommendations were developed and presented to key stakeholders. To help decrease the number of transfers to outside hospitals, key stakeholders have identified that expansion of the hospitalist group to include nurse practitioners and physicians assistants in conjunction with more telehealth consultation services will hope to improve local healthcare.