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Why telehealth is fueling the move towards micro-hospitals

The technology is helping facility operators provide faster, more personalized service

Jeff Lagasse, Associate Editor

The growth of micro-hospitals, where small neighborhood hospitals offer care tailored to the specific needs of a community, has been dramatic in recent years. And companies that are building and operating these facilities are relying on telemedicine to help them provide faster, more personalized service.

Cited as a new trend in healthcare in U.S. News and World Report, micro-hospitals -- sometimes called neighborhood or community hospitals -- typically have eight to 10 short-stay beds and provide the inpatient care, emergency care, imaging and lab services typically performed in larger hospitals. Some also offer outpatient surgery.

[Also: Almost all large employers plan to offer telehealth in 2018, but will employees use it?]

Cropping up in communities in more than a dozen states, micro-hospitals offer an appealing combination: They are cheaper and faster to build than larger hospitals; they can be tailored to the specific needs of a community depending on age, economic profile and other factors; and they offer a wider range of services than an urgent-care center. Not to mention the quick service.

Research indicates these hospitals may engender a symbiotic relationship with telemedicine, with the growth of one helping to fuel the other. This is especially true given the projected growth in the number of nurse practitioners and physician assistants: A report by the U.S. Health Resources and Services Administration estimates that by 2020, the supply of primary care NPs is projected to increase by 30 percent, from 55,400 in 2010 to 72,100; and the supply of primary care PAs is projected to increase by 58 percent, from 27,700 to 43,900 over the same period.

[Also: Are micro-hospitals the answer for systems looking for low-cost expansions? They might be]

The HRSA also reported a projected shortage of 20,400 primary care physicians against demand in 2020. A similar shortage of specialists like intensivists, pulmonologists, neurologists, cardiologists, psychiatrists and others, particularly in rural America, holds the door wide open for telemedicine to fill the gaps.

Telemedicine makes specialists available practically 24/7. A group of specialists who contract with the telemedicine provider handles calls, and can respond either by phone or text message. Or, if the situation warrants, the physicians can diagnose and prescribe treatment for the patient via two-way videoconferencing technology, a cart or robot equipped with diagnostic equipment and a monitor that provides for face-to-face communication with patients and staff.

The telespecialists might be in the same state and time zone, across the country or, in some instances, halfway around the world, but they must be licensed in the state and credentialed by the hospital at which they are practicing. Wherever they are, response time is usually fast. According to the research, teleneurology specialists typically achieve an average response time of 3.5 minutes and an average diagnosis and treatment time of 21.8 minutes.

A Nemours study recently supported the use of telemedicine to reduce costs for both the patient and hospital system, while maintaining high levels of patient satisfaction. Those who use telemedicine for sports medicine appointments saved an average of $50 in travel costs and 51 minutes in waiting and visit time, according to the study.

The research, which was conducted in a pediatric sports medicine practice, also found that the percentage of time spent with the provider was significantly greater for telemedicine than for in-person visits -- 88 percent versus 15 percent of visit time.

Twitter: @JELagasse
Email the writer: jeff.lagasse@himssmedia.com

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