How technology plays an important role in providing quality care to our community.

Technology vs. The Rural Community

Lindsey SaundersNURS 7350

July 24, 2013

Approximately 44% of Alabama residents live in rural areas.

Manufacturers, construction workers and farmers make up the majority of rural Alabama workers.

The Rural Community

61 out of 67 counties in Alabama are considered medically underserved.

9 counties are without any type of hospital. In 2011, the poverty rate for rural Alabama

was 21.8%.14% of Alabama residents lack medical

insurance.

Medical Dilemma

The average commute time to the nearest hospital is about 24.1 minutes.

Public transportation is not an option for most Alabamians due to unavailability or financial reasons.

Going the Distance

In rural Alabama, deaths from heart disease are 47-78% higher than urban areas.

Deaths from cerebrovascular accidents are 56% greater in rural areas.

Motor vehicle accident victims have a 65% greater chance of losing their life if in a rural area.

Time = Tissue and Survival

The ability to meet the needs of patients hinges on the hospital’s advancement in technology.

In 2008, less than 3% of community hospitals were utilizing electronic medical records.

Many rural facilities lack important diagnostic testing and/or someone to interpret the results.

They lack many life saving procedures and frequently transfer patients to urban facilities causing a prolongation in treatment.

Rural Hospitals

STEMI patients being transferred from rural hospitals are associated with longer “door to balloon time” and a higher incidence of major adverse cardiac events such as death, stroke, and recurrent ACS.

Focus on the Heart

To determine the severity of patients from rural communities admitted to an urban hospital due to transfer from another facility or from bypassing a local hospital because of lack of resources and technology.

Goal Statement

1. Determine the percentage of patients from rural communities that the Cath Lab/ CV Recovery Unit at Baptist Medical Center South serve.

2. Gather and analyze data to determine the top reasons for transferring and averting from rural facilities.

3. Identify the needs of hospitals and patients in the rural setting to decrease the number of avoidances and transfers to other regions.

4. Develop strategies to aid the rural facilities and population in obtaining the resources and technology needed to provide better patient care.

Assessment Objectives

Sample population: 12 patients from rural areas transferred to BMCS for cardiac procedures.

Top reason forTransfer: Use of the Cardiac Cath LabDiversion: Low level of trust with rural

hospitalsImprovements:

EquipmentQuality of CareSpecialty of Physicians

Assessment

Low incomes and socioeconomic statusInsurance CoverageLack of transportationPoor medical careStressful/ physically demanding jobsLower level of education

Factors Affecting Overall Health

ObesityDiabetesCancerHeart diseaseOther injuriesSmokingPhysical InactivityPoor dietLimited use of seatbelts

Health Disparities

1. Patient EducationSmoking, Diet, Lifestyle, MedicationsWhen do I need to go to the hospital?Education needs to be simple and continuous

2. Rural Healthcare EducationDiagnostic TestingProtocols for STEMI & CVA

Prevention and Promotion

3. Rural Healthcare FundingFunding is needed to facilitate better

technology and education. U.S. Department of AgricultureHealthcare Reform

4. A new innovative approach is to outsource rural hospitals' IT infrastructure to another larger, more technologically advanced hospital in their region.

Prevention and Promotion

The rural health epidemic is continuing to grow as practitioners are becoming scarce.

This population deserves safe, quality care. Future strives and the use of advanced

practice nurses in this area can hopefully make a difference in this underserved population.

Conclusion

Deshmukh, A., Hilleman, D., Haroom, S., Bansal, O., Smer, A., Kanuri, S., … Esterbrooks, D. (2013). Outcomes in patients undergoing rural interhospital transfer of st elevation myocardial infarction for percutaneous coronary intervention. JACC: Cardiovascular Intervention, 6(2).

Reddy, M.C., Purao, S., Kelly, M. (2008). Developing it infrastructure for rural hospitals: a case study of benefits and challenges of hospital-to-hospital partnerships. Journal of American Medicine and Informatics, 15, 554-558. Doi: 10./197/jamia.M2676

Shepard, B. (2012). Uab creates statewide network to expand healthcare in rural alabama.. UAB News. Retrieved from: http://www.uab.edu/news/latest/item /2694-uab-creates-statewide-network-to-expand-health-care-in-rural-alabama

Surgenon, S.D., Corwin, H.L., Clerico, T. (2001). Survival of patients transferred to tertiary intensive care from rural community hospitals. Critical Care, 5(2).

The opportunities and challenges for rural hospitals in an era of health reform. (2011, April). American Hospital Association: Trendwatch.

References

Grading CriteriaTopic Possible Points Points Earned

Introduction or Background 5

Assessment Tool 20

Factors affecting overall health 20

Health Disparities Identified 5

Strategies--- suggested; not required to be implemented 25

Well-crafted, scholarly PPT 15

References on last slide 5

Submitted by due date and time 5

TOTAL 100.points