Can Telemedicine Solve the Rural Healthcare Crisis?

Intermountain’s strategy isn’t entirely new. The health system has long been recognized for its telemedicine and digital health programs and strategies. But Liljequist notes many of those programs have existed in their own silos, serving certain populations or hospitals; whereas this effort aims at an enterprise-wide platform that connects not only hospitals and other sites within Intermountain, but outside the network as well.

“What if we systemize all of this and create what we call a virtual hospital?” he asks.

The effort started, he says, with a plan to lay down a telemedicine infrastructure to stabilize small, rural, critical-access hospitals, giving them on-demand access to clinicians to help them treat more of their patients rather than sending them on costly and risky transfers to larger hospitals. That network now serves roughly 33 hospitals within Intermountain as well as about 40 outside the health system who contract for telemedicine access.

Liljenquist says the cost to those small hospitals is small, but the service helps them to keep an extra 13% to 18% of their patients. This not only reduces transfer costs but allows the hospital to capture charges and improve care management.

Liljenquist envisions critical-care access hospitals using this platform to access on-demand specialists from Intermountain, enabling on-site staff to care for patients who would otherwise be transferred to a larger facility. This, in turn, improves the hospital’s census, stabilizing finances and keeping patients in their community, closer to home.

“You’re paid on a DRG or on a code based on the complexity of the case and the more complex you can handle locally, the better your reimbursement is,” he notes.

This is especially important, he says, in light of the growing senior population, which will demand care closer to home (not to mention the roughly one-quarter of Intermountain’s doctors and nurses that are Baby Boomers themselves).

Collaboration with key technology and healthcare organizations is important, Liljenquist says, because Intermountain can’t do this alone. A telemedicine platform spanning not only hospitals but health systems needs good digital health tools and a strong EHR to coordinate data storage, analysis and exchange, hence the participation of both Epic and Microsoft.

And with this strategy taking aim not only at the growing senior population but access and equity issues affecting rural communities, both the Gates Foundation and West Health are on board.

“It’s not just consolidating programs, systematizing what we do, agreeing on all the technology, but really mapping and making sure that that when we go out and offer these services that we’re offering them consistently,” he says.

Liljenquist sees this platform as a model that could be embraced by other large health systems, creating hub-and-spoke telemedicine networks across the country.

“What can we share and what we’re hoping is, is that there’s interest from other folks who say, ‘Oh, we might be able to do something similar,’” he says. “We might be able to learn. We might be able to create really a unique overlay that helps stabilize rural healthcare nationwide. That’s what we’re interested in figuring out.”