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Affordable Care Act Grant Connects Rural Nursing Homes to Geriatric Specialists Via Telemedicine

Dollars and PillsResidents of long-term care facilities in parts of South Dakota, Minnesota, Iowa and Nebraska stand to benefit from a major Affordable Care Act grantthat will dramatically improve Sioux Falls, South Dakota-based Avera Health’s telemedicine connections to about 30 rural nursing homes. The nearly $9 million grant will establish robust telemedicine links between the facilities and Avera’s main Sioux Falls location, at which on-call geriatricians will be available to remotely examine patients, confer with onsite primary care staff and recommend further treatment or specialist visits if necessary.

Immediate Benefits

In the short term, this grant should reduce the number of long trips that residents of rural nursing homes need to make to the Avera’s Sioux Falls facility. In turn, this will enhance resident safety while reducing the time and expense required for transportation. These savings could be reinvested in other areas of care as well as in programs that improve long-term care facility residents’ experiences.

Quality of Care and Complex Cases

The grant also aims to bolster the quality of care that rural nursing home patients receive. According to a USA Todayarticle on the initiative, “a big benefit of telemedicine could be to spread South Dakota’s few geriatric specialists to more parts of [South Dakota and surrounding states].” Since telemedicine technology works on a 24-7 basis and leverages geriatricians who are already on call at Avera’s facility, it allows experts to consult with more patients and could reduce the need for in-person appointments that may be scheduled months in advance.

Avera’s financial infusion could even address the needs of seriously ill residents who have complex medical histories. According to Deanna Larson, the vice president of Avera’s eCare division, the grant will make experts in specialized geriatric drugs available to ensure that patients receive the best possible care from their own beds. While critical cases may still require transport to Avera’s main facility, these expert-patient telemedicine consultations and evaluations could reduce the need for hospital admissions – and readmissions – as well.

A Culture of Innovation

In fact, the Centers for Medicare and Medicaid Services (CMS) have earmarked up to $1 billion in “innovation award” grants, a category that includes telemedicine services, under the Affordable Care Act. The Avera telemedicine program is one of 12 initiatives that received funding during the latest round of grant announcements, and CMS will study it closely in the coming months and years to determine whether and how it should be expanded and emulated. If the program can improve patient outcomes and health system efficiency for the geriatric population, it’s likely to be copied in other rural areas around the United States.

The Avera grant is just the latest sign that federal agencies – and health systems from coast to coast – believe in telemedicine’s outcome-improving, cost-reducing power. Geriatric health is far from the only area of medicine that stands to benefit. For instance, Telehealth Promotion Act of 2012 offers “grants to eligible entities to establish national centers of excellence for depression, which are required to, among other things, use electronic health records and telehealth technology to coordinate, manage, and improve access to healthcare.” Section 10333 allows for “grants to support the development of community-based collaborative care networks,” including those that leverage telemedicine.

More generally, the ACA and related programs create a number of opportunities for the use of telemedicine services, including:

  • Remote monitoring of at-home and nursing home patients
  • Telehealth services for rural behavioral health patients
  • Improving the ability of non-medical support professionals and non-specialists to care for patients with limited mobility and chronic health conditions

Going forward, it’s likely that rural nursing home residents and other populations will benefit from more telemedicine-focused grants like Avera Health’s recent $8.8 million infusion. That’s great news for patients, their families and their medical support teams.



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