Strengthening rural hospitals is a vital part of the fight against COVID-19

Rural hospitals may have treated fewer COVID-19 patients than their urban counterparts, but the pandemic’s impact on these facilities has been no less devastating. Rural hospitals are often much smaller than hospitals in urban or even suburban areas, have fewer ICU beds, ventilators, and specialists, and are often in remote locations where help from other hospitals is not readily available. What’s more, they tend to depend financially on revenues coming from procedures and care delivered on-site. When COVID-19 hit, not only did they have to stop performing elective procedures, but they also saw fewer patients in general as fear of contracting the virus prevented people from seeking emergency care

While larger facilities have employed telehealth, training programs, and specialty services to address the challenges of delivering care during COVID, investing in such resources may not be feasible for many rural organizations. However, partnering with larger, well-funded institutions may open doors to resources that otherwise would be out of reach.

These types of relationships not only benefit hospitals in remote locations, but have the added perk of strengthening referral patterns and providing transfer options both to and from the facilities involved. Partnering with nearby tertiary care centers for specialty consults via telehealth can help rural hospitals keep patients in their own communities and ensure that they receive the care they need when transferring to another facility is not recommended or even an option.

Partnering with larger institutions for telehealth services expands a rural hospital’s care delivery options. For example:

• Remote ICUs can monitor inpatients from anywhere in the world;
• Specialists can lead remote teams via virtual huddles and consults;
• A nursing team at a critical access hospital can work closely with internists and ICU nurses across great distances to care for patients on ventilators;
• COVID patients recovering at home can be monitored by caregivers in another state if needed; and
• Routine outpatient visits can be scheduled with providers located anywhere.

These arrangements are also advantageous to tertiary care centers, as rural hospitals can help with patient overflow during times of bed shortages. Recovering or less ill patients can be transferred to rural facilities and monitored remotely. By working together, rural organizations and their more populated counterparts can optimally use all available resources to provide the highest-quality care for patients in the most appropriate location.

Training, recruitment, and technology solutions are important ways that organizations can further join forces to support their communities. Training agreements allowing visiting staff to work and learn in large hospitals give caregivers experience with conditions that may be less common in rural areas but still require immediate and expert care. Contracting with large hospitals, which already have extensive mechanisms in place for recruitment, can extend the reach and possibilities for filling positions in rural areas. Partnering on technology solutions (e.g., EHRs, telemedicine platforms, digital imaging, self-scheduling software, patient portals, etc.) that smaller hospitals might not be able to afford on their own can also provide for safer referrals and handoffs for patients who need higher levels of care.

In this highly mobile, ever-connected world, caring for those in need happens best through partnerships. Working together to design innovative and flexible models across various levels of care, facilities, and distances can ensure that all available resources are being used effectively and efficiently. These partnerships build long-lasting relationships and reduce patient suffering caused by fragmented care.