Much of the public attention on health care — particularly over the last few months — has been mired in bitter political debate and predictions of catastrophe from both sides of the aisle. The showdown has so dominated societal discourse that it’s easy to overlook the success stories — places where health care organizations are improving patient care and outcomes, uncovering innovative ways to contain costs and expanding access for those most in need of care.One of those success stories can be found in Mississippi, where an innovative approach to telehealth at the University of Mississippi Medical Center has significantly expanded the number of patients served in a state where 54% of residents live in rural areas, and 64% have to drive at least 40 minutes for specialty care. It’s sorely needed there — the United Health Foundation put Mississippi in the 50th spot in its overall annual health ranking. That includes coming in 48th in preventable hospitalizations, 50th in infant mortality and 48th in access to primary care physicians.
The Center for Telehealth has existed at UMMC since 2003, but in 2014 administrators put to the test the effectiveness of telemedicine on treatment of diabetes, a disease which affects 14.7% of Mississippi’s adults, up 19% from 12.4% over the last four years. An 18-month pilot program known as the Mississippi Diabetes Telehealth Network launched in 2014 to serve patients with uncontrolled diabetes in Sunflower County in the Mississippi Delta, one of the most underserved regions of the country. The program billed itself as the first of its kind in the nation.
“We have a lot of health needs in Mississippi. Our health outcomes are not great and our state is very rural, so telehealth is the perfect solution to help improve health outcomes in Mississippi,” Michael Adcock, executive director of the UMMC Center for Telehealth, told the Daily Mississippian in 2016. “If you look at the way the health providers and health care recipients are dispersed, it’s reversed. Well over 60 percent of the providers in Mississippi are in urban areas and well over 60 percent of the patients are in rural areas.”
Participants were provided with tablets loaded with technology that allowed them to transmit their blood sugar directly to their RN Care coordinator. The preliminary results of the first 100 patients were remarkable: compliance with medication reached 96% and compliance with scheduled health sessions reached 83%. On average, these patients saw a 1.7% decrease in their A1C — a measure of blood glucose — and not a single participant from the first 100 patients in the study were hospitalized.
UMMC estimates that nearly $340,000 in health care costs was saved during the first 100 patients enrolled in the pilot, and that the projected Medicaid savings for adoption of the program among just 20% of the state’s diabetic population would reach $189 million each year. The program has been attracting attention from around the globe as an example of the potential of telehealth in improving access and outcomes for rural Americans.
“Mississippians are now able to stay in their community and get access to services that previously were only afforded to people in an academic medical center,” said Dr. Kristi Henderson, the former chief telehealth and innovation officer for UMMC in an article for the Mississippi Development Authority. “Everyone wins with this model — the individual gets convenient and quality health care, the community keeps its health care dollars and UMMC maximizes the use of their health care experts. This model uses our state’s resources in the best way possible.”
Now the success of the pilot is even further bolstering the health system's commitment to telehealth. UMMC is using telehealth for treatment in 35 medical specialties for adults and children, including mental health services, obstetrics, obesity, COPD and dementia and Alzheimer’s care. It offers telehealth for schools to serve as a virtual school nurse, provides eICU monitoring for critically ill patients, and utilizes telemergency technologies that it says can help avoid 850,000 emergency transports totaling $537 million in annual savings. The center has recorded more than 500,000 patient encounters since 2003 and today has 218 service locations providing care in 69 of the state’s 82 counties.
“We are offering this service not only to patients in Mississippi, but outside of the state as well,” said Adcock. “We want the success of this program to impact as many lives as possible.”