COMMENTARY: Technology brings world-class health to rural Minnesota

By David Greenwood-Sanchez
Policy Research Associate, Minnesota
2020david.greenwood@mn2020.org
One common struggle in Minnesota — and in most states — has been finding a way to improve access to health care in rural areas. Although there is still a long way to go, the Minnesota Telehealth Network is offering a new answer to this problem.

The main troubles facing rural health care are no secret. The lack of physicians and health care facilities, coupled with high rural poverty rates has been a perpetual public policy nightmare. Unfortunately, rural citizens are still bearing this burden, and all-too-often find themselves driving long distances for lower quality services, or not receiving care at all. The situation is especially troublesome in cases of specialty care, with rural Minnesotans are often forced to visit the Twin Cities while paying for meals, gas, lodging, forgone wages, etc. This is where the Minnesota Telehealth Network comes in.

Telemedicine (a subset of the broader term, telehealth) attempts to extend health care to patients through the use of modern telecommunication technology. This can take the form of still image transfers, medical data transfers, or, as is now common, live video and audio transfers. Here in Minnesota, most of this is done through the Minnesota Telehealth Network, a partnership of 32 rural hospitals in northern Minnesota and eastern North Dakota, which works with four specialty health care providers to bridge the gap between rural patients and urban-based medical specialists.

“Our telemedicine project is entirely face-to-face consultations with specialists,” says Cindy Uselman, Project Director of the MN Telehealth Network. Although the specialist is only there via video, there is always at least one nurse trained in telehealth present, to help administer the services. “Patients describe it as just like being in the same room.”

Telemedicine boasts many advantages over traditional rural health care programs. For one, it reduces the travel requirements for patients and specialists. This reduces the cost of health care, which in turn makes rural health care more accessible. Additionally, telemedicine keeps revenue in local communities, since a share of the money goes to the local hospital instead of solely a distant specialty clinic. This can also help to keep smaller rural hospitals afloat.

“It makes sense for everyone. We’re finding that people are getting on board because of the cost savings from reduced travel. It also works well for small hospitals, and brings patients a high level of service.”

Specialist doctors are also getting on board.

“When I first came here in 2002, no one aside from the doctors who were already with us wanted to hear about this,” says Zoi Hills, Telecommunication Coordinator at the University of Minnesota Medical School. “People were shutting doors in my face. Now specialists are coming to me, asking how they can get involved.”

Although the network has been around for 15 years, it has blossomed in recent years as the quality of service has risen. Currently, the MN Telehealth Network facilitates an average of more than 1,200 specialty appointments a year.

“We were pioneers back then (1994). At that time we were basically a hub-and-spoke model, centered around specialists at the University of Minnesota. Now we’ve been able to move to more of an open-architecture model, where we have access to medical specialists from around the region,” says Uselman.

Still, there have been limitations. Modern telemedicine efforts rely on dedicated high-speed lines. The problem has been that in order to further expand health care access, rural communities need to have reliable broadband access.

“Our rural infrastructure has to reach a high level of quality. We have to have a dedicated line for telemedicine to ensure the security of medical information, while maintaining a high level of service,” Uselman added.

This makes President Obama’s recent $7.2 billion broadband investment program crucial to any effort to expand rural access to health care.

Unfortunately, the Minnesota Telehealth Network may not be around when the money is dispersed. The project runs by virtue of a three-year federal grant from the Department of Health and Human Services, which is set to expire on Aug. 31. Although the network has applied for a renewal, it is unclear whether or not they will receive it. However, it is clear that without the funding, the project of expanding telemedicine will be severely limited.

“This is an operation that should be funded. Everyone is benefiting,” says Hills.

Here in Minnesota, we need to ensure that improving rural health care is kept on our public policy agenda. Minnesota has a strong history of providing excellent health services, and it would be a disservice to our rural communities if we allowed a promising project such as this to fail. Instead, we should take a more active approach in improving our rural telecommunications infrastructure and supporting the next generation of health care projects such as telemedicine.