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KBIA’s Health & Wealth Desk covers the economy and health of rural and underserved communities in Missouri and beyond. The team produces a weekly radio segment, as well as in-depth features and regular blog posts. The reporting desk is funded by a grant from the University of Missouri, and the Missouri Foundation for Health.Contact the Health & Wealth desk.

Telehealth can connect rural areas with medical care

In September, the state awarded grants to eleven rural Missouri hospitals to improve broadband internet connections speeds. The connection would be used for telehealth, a way rural towns access physicians in bigger cities electronically. KBIA’s Lee Jian Chung brings us the first of a two part series on the expansion of telehealth services in Missouri.

“Hello? Can you hear me? Tsk. One bar. This town has no phone reception,” Samuel Woodard mumbles, half to himself, as he drives through Marshall, Missouri

Woodard helps set up telehealth sites throughout the state for the Missouri Telehealth Network. He’s seen some towns that have fallen on hard times. He says Marshall seems to be holding up alright.

“It’s kind of vibrant here still. Some of the towns seem to be suffering a little bit. You can tell the impact of the city because they do not have enough physicians that might be in that community to service them so telehealth is able to fill that void,” Woodard said.

The Missouri Department of Health and Senior Services estimates that a quarter of rural counties in the state are short on primary care physicians. Forty-one do not even have a hospital. But doctors can connect with these areas through telehealth- by quickly and securely transferring sensitive medical data, monitoring patients remotely or consulting alongside other specialists using video conferencing.

Today, Woodard is at the Marshall Habilitation Center to talk to its staff about their telehealth options.

“I won’t say they enjoy it, but it makes them comfortable rather than taking them back down to the doctor or something,” says nurse Kimberly Sapone.“You know, it’s their home, it’s their own facility, and they don’t have to be taken out in public and going through that stressful situation.”

The state-run facility saved up to 500 dollars per patient by not having to pay a driver and nurse to accompany patients to Columbia for specialty care, and for the gas to get them all there. That equaled 68,000 dollars in savings for taxpayers in 2009. Missouri Telehealth Network director Rachel Mutrux says it saves time and gas for those paying out of their pockets, too.

“Missouri is a really big state. It doesn’t look like it on the map in particular. But there are parts of the state where it would take a patient several hours... three or four, sometimes five or six hours to get to their specialty care provider,” Mutrux said.

But for telehealth to work, a county needs a secure high-speed internet connection.  According to state initiative MoBroadbandNow, 30 of Missouri’s 114 counties had limited or no connectivity in 2010. But federal and state funding helped to reduce that number to just four at the beginning of this year. But Mutrux says there are still high start-up and maintenance costs for such programs.

“It’s not really about the technology, it’s about the people. You have to get buy-in from everyone in that rural clinic if you’re going to make telehealth work. Otherwise that expensive piece of equipment is used as an expensive coat rack,” Mutrux said.

On top of that, doctors are also able to earn more from face-to-face appointments rather than electronic ones. And until equipment and broadband costs are lowered, it will take grants and loans to support telehealth as it is.

In the second part of this two part series, KBIA’s Lee Jian Chung takes a closer look at the costs of starting a telehealth program, and the issues surrounding doctor’s compensation.

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