COVID-19 had a disproportionate impact on both individuals and hospitals and health systems in rural America. According to the American Hospital Association’s (AHA) Rural Hospital Closures Threaten Access report, 136 rural hospitals closed between 2010 and 2021, 19 of which closed in 2020 alone, per UNC’s Cecil G. Sheps Center. This record-breaking number of closures in 2020 can be attributed in part to financial pressures and staffing shortages.
Burnout and stress-related staffing shortages are prevalent across the healthcare industry at large, but rural healthcare providers are particularly susceptible to burnout due to the increased demands of healthcare shortages. Medical professionals were already in short supply in rural America and this mass exodus is only exacerbating the problem. The AHA reports that only 10 percent of physicians in the US practice in rural communities despite 14 percent of the population — nearly 46 million people — residing in these areas. And hospitals are struggling to recruit and retain the clinical staff that live in these areas as burnout and wage pressures make it difficult for providers to compete with other employers.
Hospitals are also grappling with a huge loss of income due to delayed and deferred care throughout the pandemic. In 2020 alone, rural hospitals lost an estimated 70 percent of their income as routine procedures and other care services were canceled, according to Maggie Elehwany, vice president of government affairs with the National Rural Health Association. In the face of these challenges, rural hospitals and health systems should turn toward digital health technologies, such as digital case support, as one measure to help reduce costs, recoup lost revenue and alleviate staff burnout.
Digital Case Support Can Help Rural Health Systems Save Time, Money and Stress
While technology can add value to nearly all corners of a hospital, there is one room in particular rural hospitals can look toward to pick up financial gains: the operating room (OR). The OR provides an opportunity for rural hospitals to reclaim surgical revenue by improving workflow efficiencies for the surgical staff. In fact, a study from Explorer found among thousands of surgeries, up to 10 percent of intraoperative time was spent on preventative delays, such as waiting on an instrument that was not ready before the procedure or having to open an instrument that wasn’t necessary in the first place, which is consistent across most surgical specialties.
Technology like digital case support platforms can help rural providers streamline workflows by reducing time spent on preventative delays with detailed step-by-step procedural guides for all parties in the OR or procedural suite. Features such as video connectivity, customized guidance for each team member and the ability to capture data during a procedure can help foster learning and collaboration, promote best practices and identify and correct inefficiencies that could impact outcomes, such as setup time and surgical delays.
Streamline Procedural Proficiency
Offering customized guidance for all parties in the OR, procedural playbooks help streamline proficiency through detailed clinical instructions integrated with relevant case recordings and data to contextualize each step of a procedure. In addition to reducing inefficiencies, these playbooks can be utilized as a training tool for onboarding new OR staff or to help scrub techs get up-to-speed quickly on a procedure they’re less familiar with. On-demand access to procedural best practices can help improve proficiency throughout the procedural suite without compromising patient safety and outcomes.
Additionally, procedural playbooks can help hospitals eliminate excess medical waste in the OR, further contributing to improved financial outcomes. When surgical team members have step-by-step guidance for a procedure, including what supplies and how many are needed for each surgery, they are less likely to bring additional, unnecessary supplies into the OR. This effectively reduces the number of products that might get opened, but remain unused, and consequently, thrown out and wasted.
Identify Surgical Inefficiencies
Digital case support technology can also help capture valuable real-time data during procedures. For example, intraprocedural data can enable hospitals to track average procedure times by physician, time a patient spends under anesthesia, or when a case is likely going to run long. By tracking and utilizing this data, hospitals can better spot inconsistencies and inefficiencies. When corrected, this can reduce the amount of time a patient spends in surgery, increase the volume of surgeries a physician is safely able to perform and increase revenue. Ultimately, this technology can help enable clinical teams to focus on what’s most important: treating the patient and delivering the best outcomes.
Scale Access to New Procedural Innovations and Techniques
Digital case support can bring best surgical practices to rural hospitals across the country without compromising cost, time away from patients or work-life balance. By connecting physicians and medical device representatives inside and outside the OR or procedural suite through high-fidelity live streaming, it helps enable greater remote collaboration. Expanding access to a wider field of key opinion leaders is especially important for rural hospitals. It also affords physicians based in rural locations the opportunity to train on new procedures or new technologies without having to travel for an in-person observation. In rural areas, where there may be limited access to specialized surgical care, this can play a critical role.
In one case, three physicians from Texarkana, Arkansas were planning to travel to Pennsylvania to train on a new minimally invasive cardiology procedure with one of the top specialists in the country. The travel time for in-person observation would have resulted in 32 hours away from their patients and their practices would have lost $80,100 in revenue.
By conducting their training remotely through digital case support technology, expenditures were reduced to zero, the lost revenue was dramatically reduced to only a half-day of physician time and there was no added disruption to the physicians’ personal lives. With less time spent traveling, physicians can dedicate more time to patient care.
While there are several factors that contribute to the financial outlook for rural healthcare, technology such as digital case support can alleviate some of the strain by helping hospitals reclaim lost revenues from surgical procedures, reducing inefficiencies in the OR, providing greater access to training and best practices for physicians and improving collaboration among staff.
Brandon Kim, MD, MPH, is Medical Science Liaison with Explorer, a GHX company.