AMH, Bryan Telemedicine Shaping Rural Healthcare

Before jumping into a car and logging several miles and hours on the road, doctors and patients can first connect virtually to see if that trip is necessary. Patients in rural areas can be examined and treated by doctors at any time from Lincoln, thanks to Bryan Telemedicine.

Antelope Memorial Hospital has been the pilot hospital, working with Bryan Telemedicine to offer specialized service and more efficient around-the-clock healthcare to the northeast Nebraska area.

Dr. Asha Schweitzer, Board Certified Family Practice, is one of the physicians serving patients at AMH from her location outside of Lincoln.

“Our ultimate goal is to keep people in Neligh, but we always know that we have access to other facilities if the patient would require that. We are using telecommunication and technology to deliver clinical care. Antelope Memorial was our initial site. It’s still in the progressive stages of developing more sites. Crete is the second site that we are using just hospice services for. There are multiple other sites interested in telemedicine,” Schweitzer said.

Having additional access to services is key for rural healthcare providers and community members who don’t have to travel near as much as they used to if they can get their care and treatment virtually.

Why Neligh?

Antelope Memorial Hospital Director of Nursing Merry Sprout said this on-line and off-line partnership with Bryan Health has provided a solution so some of their challenges as a rural healthcare provider. Serving seven counties in northeast Nebraska, AMH has been able to lean on Bryan Health to offer more specialist care in this capacity for their patients.

“Several years ago, we needed some assistance in our mental health area. All small, critical-access hospitals have to have a network hospital like Bryan Health that helps us when we need policies, advice, or someone to consult with, and training for staff,” Sprout said.

Shane Fleming, Chief Operating Officer for Bryan Telemedicine, said Antelope Memorial Hospital was a prime fit for piloting this program.

“When we came to Neligh, we were looking for a partner that had a strong administration and a strong medical staff and a strong nursing staff and an innovative thought process that wanted to go down this road with us because they knew they needed to improve the care and access overall and blunt some of the long hours of local providers and provide a better work-life balance for their local providers,” Fleming said.

How It Works

Antelope Memorial Hospital has been putting telemedicine to use in several ways to advance the rural health care they provide. As physician can assess the patient over the screen, the nursing staff now wears even more hats. From being videographers to being the hands-on part of the examination, the nurses play a significant role as the hands, ears and eyes of the physician as they work very closely together to pull off this type of encounter.

Fleming said, “There is a lot of effort that goes into the training, both prior to the program launch and during the program launch, and post program launch. It is mission-critical to have successful telemedicine encounters, to have have strong tele-presenters. The goal is to make it a win-win-win for all the parties involved and ultimately the community wins by keeping more patients in the community.

Telemedicine enables local providers to offer more specialty services to the hospital. Fleming said the only way to do that effectively is to have a clinically relevant solution that has some diagnostic capabilities. This program allows physicians to assess patients virtually and allow the technical assistance and support of an exam conducted by a physician with the help of registered nurses.

Dr. Sweitzer said, “With telemedicine, we can use it with anyone that comes into the ER to assess them using telemedicine. If someone comes in with a heart attack, we can manage them really with any type of orders or imaging needs to be done can be managed on the internet using the video, using the special tools that we have. With the stethoscope, we can see EKG real time, get results real time, just as a provider in the ER would.”

Overcoming Rural Healthcare Challenges With Telemedicine

Every rural hospital has a different situation and this telemedicine program can be customized to fit what what each facility needs; however, offering additional support around the clock has been a game changer for each rural health care provider.

Sprout said another need telemedicine is fulfilling at AMH is in the emergency room.

“We just keep seeing our numbers go up and we are getting busier all of the time,” Sprout said. “It’s very nice that we can call up doctors like Dr. Sweitzer. They have done an excellent job working with our staff, and our patients have been very happy with the care provided.”

Fleming explained that some hospitals only have mid levels to operate the emergency department, and they are struggling to have any type of provider covering the emergency department.

“It’s a big deal to offer support for these hospitals. And for the patient’s perspective, there are a lot of things that go into the decision whether or not to transfer somebody. Those questions that can be answered and we can treat those admissions virtually to help offer reassurance to local providers and nursing staff in the hospital to allow patient can stay there,” Fleming said.

Beyond that, telemedicine works closely on both sides to maintain the clinic and the functionality of the clinic.

“We work with specialist physicians to enhance their workflow to make them more productive on their side and flexibility to see patients in Neligh and patients in Lincoln. Trying to find clinical relevance that Neligh and Antelope Memorial can bring to their patients to offer increased access, provide more services locally and keep those patients local. Financially, that is a big deal for smaller hospitals.” Fleming said.

Top-Quality Healthcare In A High-Tech Way

Sprout said she is proud of the AMH nursing staff how they have taken on the extra responsibilities and learning curve with being the pilot hospital for telemedicine.

“We had a nurse that just became our champion for this and she has made it her mission to practice with the doctors as often as she can because it was a learning curve for both the providers and the nurses here. It is finally working out, and being the pilot, it has been change, and that is not always easy,” Sprout said. “When we think we have learned the process, a week later, it has changed because we found something else that would work a little bit better. I am hoping that the next hospitals that go on have it a little bit smoother. It has been well worth it for what it has done for our patients and the hospital.”