UNIVERSITY OF UTAH'S TELEHEALTH SERVICES HELP BRIDGE GAPS BETWEEN URBAN & RURAL HEALTH CARE.

• Author: Dark, Stephen

Picture a small emergency room in a rural county hospital. A patient has had a stroke. If the sole physician on duty administers a drug called tPA within a narrow window of time, chances are the patient will make a near-complete recovery. Some rural providers, whether lacking confidence or for other reasons, send stroke patients to University of Utah Hospital in Salt Lake City instead. By the time they get there, there's nothing doctors can do. "We have many patients that arrive at the hospital only for our clinical team to say, 'Sorry, the only option you have is rehab,'" says Nate Gladwell, a senior director of operations at University of Utah Health.

This is where U of U Health's Telehealth Services, which use video to connect rural providers with urban-located specialists, can step in. The rural physician makes a video call to a specialist ICU or critical care doctor and lays out the patient's situation and treatment plan. "Much of the time, the specialist approves the plan of attack," explains Gladwell, who joined U of U Health in 2012 to help expand Telehealth. "Telehealth allows us to be much more present in the rural world and reduces that sense of isolation that providers can feel, particularly when they face complex, challenging decisions for patients."

Rural America represents 97 percent of the

United States landmass but only 20 percent of its population, many of them elderly, sick, and poor, according to the National Institute of Healthcare Management. U of U Health's Telehealth Services, which works with more than 80 regional locations, supports those addressing rural health care needs in the Mountain West. "We wanted to export specialty knowledge out into rural locations to help our partners care for patients better," Gladwell says.

One such partner is Vernal's Ashley Regional Medical Center in northeastern Utah. Ashley Regional--owned by LifePoint Health--serves Uintah, Duchesne, and Daggett counties in Utah and Rio Blanco County in Colorado. Its 24-hour ER treats more than 14,000 patients annually.

Close to the heart of Dinosaurland, as Vernal is famously known, Ashley Regional has been able to "evolve our care to accommodate pretty much every need that comes through our hospital," says chief clinical officer Greg Gardiner. "Certain things we have to send out."

Gardiner grew up in Vernal but never thought he'd call the town of 10,000 his home. While it was the new job that brought him and his family back six and a half years...