Federal grant will allow AU Medical Center to create connection with five rural hospitals

A new federal grant will allow Augusta University to create a two-way connection with emergency rooms at five rural hospitals, helping them gain expert consults and potentially opening the way to provide new coverage.

 

The move is critical at a time many of those hospitals are struggling to recruit physicians, a situation that could only be worsened by a looming physician shortage.

U.S. Rep. Sanford Bishop, D-Ga., announced that a $368,501 Distance Learning and Telemedicine Grant for AU had been included in language he submitted for the FY2017 spending bill. The grant will be used to create an Emergency Telehealth network for rural Georgia by connecting AU physicians with counterparts at five rural hospitals: Wills Memorial Hospital in Washington, Ga., Emanuel Medical Center, Miller County Hospital, Crisp Regional Health Services, and Washington County Regional Medical Center.

“It’s actually a very exciting grant that allows us to build on our prior successes with telemedicine,” said Dr. Richard Schwartz, chair of the AU Department of Emergency Medicine and Hospitalist Services. In addition to Bishop, the grant got a lot of support from the state’s congressional delegation, including U.S Sens. Johnny Isakson and David Perdue and U.S. Reps Jody Hice and Rick Allen, he said.

“Many of our rural communities do not have reliable access to healthcare, something I have been committed to changing,” Allen said. “I believe that this grant will improve response times and overall emergency care to the rural, minority and underserved populations in Georgia’s 12th district.”

The grant will allow the creation of a “hub and spoke model” similar to how AUMC already connects with many rural hospitals through the REACH system to provide expert consultation on stroke patients, Schwartz said.

“It’s really taking the things that we’ve learned in the REACH program with stroke but applying them to other conditions,” he said. AU contributed $57,551 to help create the new network.

In addition to a two-way connection, the grant will also provide equipment that can transmit from those locations to AU, such as digital stethoscopes and ultrasound. With those images, it will allow the experts at AUMC to help “walk through” less-experienced providers in more complex procedures that could allow the patient to remain at that facility instead of having to be transferred, Schwartz said. For instance, a video camera on a digital laryngoscope would allow the remote physician to see and help guide the intubation of a patient, he said.

The system will also aid in triage to more quickly identify those patients who do need to come to Augusta. Part of the grant is to set up a tele-EKG telemetry system at the hospital in Washington County as well as in its ambulance service that could more quickly identify those having a particular kind of heart attack that would need a cardiac catheterization, that the county hospital cannot provide, Schwartz said. Once identified, a helicopter can be dispatched and the cath lab readied so the patient is brought directly to Augusta instead of having to go first to the county hospital and then be transferred, he said.

“We essentially should be able to cut the time down from diagnosis to cath lab to virtually the same as what we would have in our community here,” Schwartz said, which could help improve patient outcomes.

The network should also lend itself to an idea being promoted at AU of training advanced practice nurses alongside Emergency Medicine residents, providers who could then staff rural Emergency Rooms with the backup from Augusta, Schwartz said.

“This is ultimately where the real strength of this project will come in,” he said. “I believe that this strategy with training advanced practice providers, placing them in rural settings with good board-certified Emergency Medicine physician backup and oversight, will allow us to be able to improve the health outcomes in rural Georgia in a very cost-effective model. There is a physician shortage in the rural hospitals and using that model we should be able to staff with advanced practice providers and be able to deliver that higher level of care using technology through telehealth.”

The pilot project to start that training has yet to be funded but one of the hospitals in the new network, Miller County Hospital, is already staffed primarily by advanced practice providers, Schwartz said.

“This will give us an opportunity to really validate that model,” he said.

Reach Tom Corwin at (706) 823-3213

or tom.corwin@augustachronicle.com.

IMPORTANT TO KNOW: There is a looming shortage of physicians nationally, where the U.S. will be short between 40,800 and 104,900 by 2030, according to the Association of American Medical Colleges. Rural hospitals in Georgia are already struggling to recruit and retain physicians. Telemedicine is seen as a way to help deliver care in rural areas through two-way technology that can connect a rural patient with a physician at a large urban medical center and is already in use in many ways throughout the state. Augusta University is working on a model of training advanced practice nurses alongside residents in Emergency Medicine as a way of providing additional skills that would then allow those providers to be placed in rural Emergency Rooms, with backup from Emergency Medicine physicians in Augusta via a new Emergency Telehealth network.

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