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Strategies for rural health systems to remain competitive in today’s healthcare environment

By Linda Spokane

Remaining competitive in today’s healthcare environment takes on a different meaning and requires different strategies in our rural communities than in more urban settings.

Providing sustainable, high-quality, affordable healthcare in areas where provider shortages, lack of transportation, high rates of poverty and, an increasingly older, more frail population exist must be the priority. Only then can the focus shift to expanding choice and minimizing cost. This requires a multi-pronged, multi-disciplinary approach that addresses staffing challenges, geographical barriers, and meeting the social as well as medical needs of the population.
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1. Recruiting and sustaining staff in rural areas: Although nearly 20 percent of the population live in rural areas, only 10 percent of physicians practice in these settings. One strategy rural health systems can implement is to engage, train and deploy community health workers to complement the limited number of trained healthcare providers. These community health workers can provide education, make referrals, assist with follow-up, conduct home visits to those at high risk for poor outcomes, and support care coordination. Since they are part of the community they serve as healthcare professionals, they can foster close, personal relationships with the population and make connections to key community-based organizations (e.g. social services, faith-based entities) as well as to the health care system. Using community health workers to enhance existing formal healthcare services will only strengthen the capacity to care for those in rural communities.

2. Addressing geographic barriers: Technology has the potential to reduce the barriers to deliver high-quality and affordable healthcare to a geographically dispersed and oftentimes isolated population. For providers, this can take the form of electronic consultations that would consist of a virtual exchange between the primary care provider seeking guidance from a specialist outside of a face-to-face visit. This may help eliminate unnecessary referrals and trips to specialists that are often a hardship to those living in rural communities.

For patients, telemedicine and telehealth can help reduce the number of in-office visits required, especially for older adults with multiple chronic conditions. Being able to self-monitor vital signs and push results to providers regularly, and receive frequent feedback on progress, can help this vulnerable population remain independent and stable for longer periods of time. In addition, although rates of depression, substance abuse and behavioral health diagnoses are increasing in all areas of our country, there is a well-documented shortage of clinical psychologists and psychiatrists in rural communities. Advances in telemedicine and remote patient monitoring offer one solution to this ever-growing problem.
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