Four rural hospitals in high-tech pilot program

For residents of some Georgia counties with no hospital and few health care options, new choices are on the way.

“We hope to achieve better care for our patients and better service to our community,” said Steve Gautney, president and CEO of Crisp Regional Hospital in Cordele, one of four hospitals to take part in a pilot program announced by Gov. Nathan Deal recently.

The four will join a grant program totaling $3 million meant to help rural health care providers leverage technology to relieve cost pressures on rural hospital emergency departments and ensure that the best, most efficient treatment is received by patients.

“We all need to be more efficient in our health care,” Gautney said.

The idea is to strengthen the links between the four pilot hospital “hubs” with partner “spokes” across the health care system: each area’s smaller hospitals, ambulances, school clinics, public health departments and physicians.

The announcement came in conjunction with the final report from Deal’s Rural Hospital Stabilization Committee, which spent the past few months studying the lack of access to critical care for rural residents. The committee started amid panic about rural hospital closings and evolved into something of a discussion about rural hospital economics and health care in general.

Geographically, most of Georgia is what the federal government calls a “medically underserved area”: a place with too few primary care doctors, high poverty or a large elderly population.

Within Georgia, one problem faced by rural hospitals is the number of people who go to emergency rooms for non-emergencies, and the amount of uncompensated care they provide. Of all ER care, about a quarter is never paid for, Dodge County Hospital CEO Kevin Bierschenk said.

At least one answer to that mismatch that the committee recommends is whiz-bang coordination.

“We have 500 sites (to access doctors), but they don’t talk to each other,” said Jimmy Lewis, CEO of HomeTown Health, an association of the state’s rural hospitals.

“We need to make sure we’re using our resources in the most responsible way, and we need to make sure that we have access for all our residents by coordinating care,” said Charles Owens, executive director of the State Office of Rural Health.

Owens said that kind of coordination can lead to care in more appropriate settings. For example, he said, if someone with a heart condition has gone to the emergency room in a large hospital and has been stabilized, that patient still needs rehabilitation and follow-up visits.

But instead of returning to the hospital, the patient now can be referred to a rehab center or physician close to home.

“That hospital kind of directs the patient to the most appropriate level of care,” Owens said.

It works if the hospital and the local “spoke” are connected by data-sharing, patient records and telemedicine hook-ups.

It’s not clear exactly what each pilot “hub” hospital will put into place just yet.

“Everything that we’re suggesting is community-owned, community-based and a community decision, and so it’s all local,” Owens said.

Some options may include telemedicine hookups among hospitals, ambulances, schools and nursing homes.

One model the committee examined, said Lewis, from HomeTown Health, was a Macon company.

Mid Georgia Ambulance runs a fleet of 65 ambulances across 11 counties in south and Middle Georgia.

They’re all loaded with technology which “enable the ambulance to serve as a mobile Wi-Fi hotspot,” said Amy Abel-Kiker, the company’s director of public relations. That means their medical instruments are online.

That saves time and possibly lives. For example, a heart monitor hooked up to the ambulance’s Wi-Fi can send the patient’s signs ahead to the hospital.

Not every hospital can handle every trauma. It’s better to bring a patient straight to an equipped hospital, even if it is not necessarily the closest one.

“If it is determined the patient is having a (heart attack), the MGA crew can be diverted to a more appropriate facility having the capability of performing a heart cath,” an intensive type of heart imaging, said Abel-Kiker.

The $3 million cost will come from elsewhere in the Department of Community Health’s budget, according to House Appropriations Chairman Terry England, a Republican representative from Auburn, Georgia. He was co-chairman of Deal’s summer study committee.

“We think we have a solution that with all the available resources that are out there, will work if we can just get everybody working on the same page,” England said. “Then I think it’s something we can replicate across the state.”

The other hospitals in the pilot program are: Union General Hospital in Blairsville, Appling HealthCare System headquartered in Baxley and Emanuel Regional Medical Center in Swainsboro.

To contact writer Maggie Lee, e-mail