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Optimum’s Executive Interview Series

Welcome back to Optimum Healthcare IT’s “4 Questions with…” series, where we interview top executives in the Healthcare IT space.  We search for leaders with track records of service excellence, who are passionate about their work and make patient safety their top priority.

In this installment, we talk with Anna Turman, CEO, Chadron Community Hospital and Health Services

OHIT: Of all the advancements in healthcare IT over the last decade, what technology do you leverage the most as a critical access hospital leader?

Anna Turman: More important than the fact that we are a Critical Access Hospital, is the fact that we are truly rural. You know you live in a rural community if there are more cows than people per square mile. Rural living is not for everyone, but those who do are tenacious and have grit – excellent characteristics to have in the healthcare industry today. Rural healthcare is built on strong foundations of providing access to care, which is an audacious goal based on the challenges of the areas.

One of our organization’s, and eight other hospitals in the Nebraska panhandle, greatest challenges is connectivity and communication. And one of the technologies that we leverage the most, which may surprise you, is high-speed broadband networking. To address this challenge, the panhandle hospitals, who are all independent competing hospitals, banded together to provide secure, cost-effective, high capacity, highly reliable, and fully redundant network access.

Implementing and leveraging high-speed network technology in the panhandle allowed our organizations and providers to enhance primary prevention, promote health, and accurately diagnose and treat illness and injury, vastly improving patient care and transitions of care. This network of 36 fibers is dedicated to healthcare, currently providing a two-gigabit redundant backbone to the internet that went live in 2012. Our network has grown to connect 23 hospitals, behavioral health providers, and associated clinics and is one of the most robust healthcare fiber networks in Nebraska. Broadband technology adds significant value through reliability, availability, and predictability which has allowed our facility to improve access to care through technological expansion and growth.

For example, technologies such as teletrauma, telepsychiatry, teleradiology and much more are widely used on our network.  I can remember the days when it would take 6 hours to send data from one patient to our heart doctors 100 miles away. I could have driven the data there faster. For our Critical Access Hospital, broadband has been an infrastructure technology that we continue to leverage to this day. It has been the foundation that has opened up so many opportunities to serve our community and ultimately provides access to care.

OHIT: What opportunities are most prevalent for healthcare IT in critical access hospitals? What technology will shape CAHs in the future?

Anna Turman: Chadron Community Hospital is small but mighty. The challenges of providing access to care and wellness in such a rural area have driven us to provide additional care outside of our walls.  Our hospital also has an assisted living and independent living facility, and several community health clinics throughout our service area. These community health clinics called Western Community Health Resources provide preventative and wellness services such as diabetes prevention classes, respite, behavioral health, family services, nutrition, and education. We are not just a hospital with inpatient beds; we are a system of care and wellness for our community.

In the short term, the most significant opportunities are telehealth and telemonitoring for home health, which will address the needs of our aging population as well as those of chronic care patients. Keeping our patients well while remaining safe in their homes prevents costly trips to the hospital. There are still challenges, however, as we have many patients that live where there is no cell service, and low-quality internet.

Broadband access is still a hurdle for homebound patients. Based on the lack of quality internet, we currently install Electronic Health Record (EHR) software on each laptop and sync data when the nurse returns to the hospital. Our home health nurses cover almost a 100-mile radius of internet and cell service “swiss cheese.”

The technology that could shape the long-term future of CAHs is the use of artificial intelligence (AI) in EHRs and patient information. The more data from predictive analytics to AI allows for more informed, efficient and positively impactful decisions.

OHIT: Is your critical access hospital using telehealth and if so, what advantages has it brought to your organization? Are there specific challenges that have kept you from using telehealth and how might those be addressed in the future?

Anna Turman: We are providing telehealth solutions because it is the right thing to do for our patients.  But it’s not without its challenges. One significant challenge of telehealth, in some cases, is that it costs more to process the claim that the minimal amount of return for the claim. Reimbursement does not cover operational costs; therefore, we don’t bill patients as the originating site. CAHs are generally the originating site, because of provider recruitment challenges in rural America, especially specialty providers such as psychiatry. Utilizing telehealth as an originating site allows us to provide access to care closer to home. Even though payors do not cover the overhead of these services, it is the right thing to do for our patients and our community.

One of the key advantages to our organization is the ability to utilize telehealth to provide services that we would not be able to provide otherwise.  Keeping care close to home.  We have our out of area nephrologist connect with our dialysis patients regularly through telehealth, preventing the provider or the patient to waste 4 hours on the road. It reduces costs but does not directly impact revenue.  We have identified community health priorities such as behavioral and mental health as a high priority and the ability to allow telehealth to enable us to connect with our patients is crucial and utilized often.

OHIT: As a CAH CEO, what steps have you taken to ensure that patients receive the same level of care as those in larger populated areas?

Anna Turman: I have found that the most significant step is doing the right thing for our patients first. Another crucial step is creating partnerships inside and outside of the community; allowing us to knock down any barriers to delivering the best quality care. True access to quality care requires equity; everyone should be able to not only receive but to choose their best care. It’s our innovative frontier spirits that drive the ability to provide the same level of care as our urban or even suburban counterparts.

We thank Anna Turman for her time and participation in our 4 Questions series.

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