Date: Friday, Feb. 21, 1997
FOR IMMEDIATE RELEASE
Contact: HRSA Press Office (301) 443-3376

HRSA Survey Shows Promise and Challenge of Rural Telemedicine

The first comprehensive survey of rural telemedicine programs, released today by the Health Resources and Services Administration (HRSA) via the web, shows telemedicine as a growing but challenging technology that promises expanded speciality health care for rural Americans. The report, Exploratory Evaluation of Rural Applications of Telemedicine, highlights rapid expansion of the technology--now in nearly one-third of rural hospitals--but identifies cost and organizational challenges to full utilization.

"This report is a snapshot showing how rural hospitals are using telemedicine to improve services and bring isolated professionals into contact with colleagues around the country," said HRSA Administrator Ciro V. Sumaya, M.D., M.P.H.T.M. "It helps us understand the strengths and limitations of telemedicine and how to design, finance and utilize this sophisticated technology for the benefit of rural Americans."

During the two-year study, conducted for the Office of Rural Health Policy, Health Resources and Services Administration, 2,472 rural hospitals were surveyed nationwide, with a 96 percent response. Key findings are:

• By the end of 1996, nearly 30 percent of rural hospitals are expected to use telemedicine to deliver patient care.
• More than 40 percent of telemedicine programs were in operation one year or less.
• Complex telemedicine networks made up of 28 percent urban metro 'hubs' that primarily provide consults and 24 percent rural and 28 percent remote 'spokes' that primarily use consults served an average of nine to 13 facilities.
• Of the 353 rural hospitals using telemedicine, 340 only use teleradiology.
  
  
• Sixty-seven percent of the non-teleradiology sites used telemedicine less than 16 times per month. But, as sites mature, they expand their offerings and increase usage.
• The most common clinical uses for telemedicine were diagnostic consults, medical data transmissions and management of chronic illnesses.
  
  
• Radiology and cardiology were the most common clinical applications, followed by orthopedics, dermatology and psychiatry.
• Nonclinical applications include continuing health professional education, administrative meetings and health care demonstrations.
• High costs limit expansion. Average equipment costs range from $135,000 for small sites to $290,000 for larger sites, and annual transmission costs can range from $19,000 to more than $80,000. If utilization is low, a single telconsult can range from $500 to more than $l,000.
• Less than 25 percent of hub facilities were reimbursed by insurers.

Other reported barriers include lack of clinical standards, scheduling difficulties and time limitations. "When we launched this study two years ago, telemedicine was more of a concept than a reality," said Dena Puskin, Sc.D., acting director of the Office of Rural Health Policy. "We now know that telemedicine is being embraced by rural facilities nationwide and that more mature systems are better utilized. Once this sophisticated technology overcomes early growing pains, it promises real benefits for rural health care delivery."

HRSA's goal is to ensure that telemedicine programs are tied directly to patient needs, according to Puskin. Future studies are expected to assess the long-term value of telemedicine and to guide the design of effective applications and services.

HRSA, located in Rockville, Md., is the lead HHS agency for ensuring primary health care services and professionals for the nation's underserved and vulnerable individuals and families. HRSA also oversees rural health initiatives and has administered rural telemedicine grant programs since 1988, with more than $8 million currently funding 20 telemedicine projects.

A copy of the full report, Exploratory Evaluation of Rural Applications of Telemedicine, is available electronically by downloading it from the HRSA Web Page. (http://www.hrsa.dhhs.gov/news.htm).

Note: HHS press releases are available on the World Wide Web at: http://www.hhs.gov.