In rural America, telemedicine is sometimes the only option for emergent patients.
As the shortage of hospitals and physicians continues to intensify in rural areas, telemedicine centers have been replacing traditional emergency departments. Physicians treat patients via cameras and computer screens, calling on nurses to provide highly specialized activities in life-threatening situations.
Video Spotlight: Telemedicine Saves Lives
This post is based on the Washington Post article, The Most Remote Emergency Room: Life and Death in Rural America, by E. Saslow, November 16, 2019, and the YouTube video, Telehealth Kiosk May Have Saved Ron Wuaten’s Life, by New York-Presbyterian Hospital, August 22, 2019. Image source: Shutterstock / Mega Pixel.
1. What are the factors that contribute to the disappearance of emergency departments and physicians in rural areas?
Guidance: Review the factors of location decisions. For emergency departments, the factors contributing to their disappearance include limited markets, small proportions of privately insured patients, and low availability of qualified labor. For physicians, the limited entertainment and cultural opportunities as well as poor career advancement and wealth prospects are deterrents.
2. What are the quality trade-offs for patients receiving virtual emergency care?
Guidance: When there is no actual emergency department within a geographic area, virtual emergency care provides patients with access to the care they need with minimal delays. Therefore, the convenience and responsiveness aspects of service quality are met. On the other hand, reliability and consistency are somewhat sacrificed. The physician making the diagnosis delegates care activities to personnel that may lack proper training and/or experience in various procedures.
3. In terms of demand and capacity, what are the similarities and differences between traditional and virtual emergency departments?
Guidance: The imbalance between capacity and demand plagues most emergency departments. In urban areas, the demand is very high and exceeds capacity, resulting in long wait times and delayed care. In rural areas, the demand is much lower but still exceeds a capacity that may be non-existent or unable to provide highly specialized care. For rural patients, long trips to actual emergency departments also result in delayed care. If telemedicine centers are well-staffed, patients may experience fewer and shorter delays in situations requiring standard, urgent care.