Enhancing Rural Health Care Coordination, Communication
Rural health care facilities face additional challenges when providing service to patients in their spread-out communities. These extra obstacles include provider shortages and low reimbursement rates for economically and medically vulnerable older, sicker and poorer patients. Add in a pandemic for additional challenges, which accentuate the need for timely patient communication and coordination.
Rural areas account for 20% of the total U.S. population, yet less than 11% of physicians practice in rural settings. With rural providers already doing more heavy lifting due to limited resources in non-urban settings, patients with higher rates of chronic conditions and an ongoing pandemic, timely and efficient communication benefits all participants in the care continuum.
Breakdown in communication ranks as one of the leading causes of medical errors. The collapse occurs between providers across all levels of the healthcare system. These communication mistakes were found to be a leading cause of preventable errors in studies underscoring the importance of clinician-to-clinician communication for safe continuity of care.
Shrinking the Distance for Effective Rural Health Care Coordination
Networks created to improve patient outcomes and reduce health costs by utilizing data analytics and population health strategies, Accountable Care Organizations (ACOs) rely on hospitals, physicians and other healthcare providers to work together. Prior to the pandemic, ACOs reached out to skilled nursing facilities to meet with healthcare providers, establish relationships and conduct assessments. Outreach efforts to improve patient coordination and communication require significant time investments from each party, especially when the entities participating operate in a rural area located many miles apart.
Even post-pandemic, these coordination efforts will continue. However, the pandemic clearly emphasized the importance of quick, cogent and centrally located communication platforms to improve patient outcomes. It’s become even more critical as providers work longer hours with less staff in rural settings, while also attempting to lower the risk of disease transmission.
“Before COVID I went out to meet facilities, and met with them at their Medicare meetings. I would get my updates, meet the patients and do the assessment of the facility,” says Traci Strauch, RN, BSN, RN case manager with IU Health Ball Memorial Hospital in the Population Health Department. “They would send me daily or weekly updates, depending on the patient's status, but then COVID made it more difficult to get those updates. I resorted to calling them and making them stop whatever they were doing during their workday to provide updates on patients.”
Strauch used Olio, a software solution, to connect with the rural skilled nursing facilities with which IU Health Ball Memorial partners. “Olio helped considerably as far as getting updates from facilities, especially during COVID,” Strauch says. “It's been a great communication tool to use instead of trying to email or call them, which is a lot more time consuming for everyone. When the skilled nursing facility uploads a form or an order, we can get it immediately.”
Facilitating Efficiency and Immediacy in Rural Health Care
For skilled nursing facilities, rural or urban, communicating with the acute-care facility that sent the patient proves crucial to successful transitions and continued care, ultimately reducing readmission rates. Both the facilities now can access real-time information through the digital communications platform. The ability to immediately and efficiently see data or escalate critical issues reduces gaps in patient care, which results in better patient experiences and outcomes.
“Communication is more efficient, especially during COVID when we are trying to limit exposure,” says Hailee Reum, Director of Nursing with Parker Health & Rehabilitation. “We can connect with the acute-care provider and hopefully prevent the patient from having to go to the ER.”
Reum shares that providers’ response times through the Olio platform average one to two minutes. Before introducing the software, her experience calling a hospital could take much longer, she says, often being put on hold before speaking to someone. Another positive Reum identified with the technology: accessibility it gives her various care colleagues to use the platform.
“Social services and therapists are also involved in communicating with each other on the platform. Everything is together, so it takes me out of being in the middle,” Reum says. “It allows everybody on the care team the opportunity to provide input without filtering through someone else.”
IU Health Ball Memorial encouraged Parker Health & Rehabilitation to adopt the communications platform as part of its accountable care efforts. “The hospital sends out a communication email that shows who's participating in the ACO and who has met their goals,” Reum says. “Our ACO looks at who communicates efficiently, and that's how we get to participate. The more you communicate, the better the outcomes, and Olio has supported that.”
