Rural EMS Post-Hospital Closure Perceptions and Impact: Telemedicine Readiness

Rural hospitals and health care systems continue to close across the nation. However, only 4% of reported rural closures had a next nearest hospital emergency room greater than thirty miles. The purpose of this study was to examine the perceived impact emergency medicine telehealth interventions have on EMTs serving Tillman County, Oklahoma, a USDA persistently impoverished county post-hospital closure where the next nearest hospital was 31 miles away. Through our qualitative study, Oklahoma State University Medical Center emergency physicians served to provide virtual consultation services to assist in appropriate care and advice in indicated medical crises as requested by EMT personnel. Key informant interviews were designed to analyze the paramedics’ perspective pre and post-telemedicine installment assessing their comfort level, role change post-hospital closure, and preference of previous rural hospital ER service pre-closure versus telemedicine post-closure regarding the pilot project. At the conclusion of the study, we intend to lead community-based focus group to receive feedback from Tillman County regarding their satisfaction, personal experiences, and willingness to continue utilizing the service in rural Oklahoma. Both are being conducted to explore alternative care rural emergency models that will serve to be the most beneficial and effective in satisfying rural areas with quality health care.