Auburn University has received a $2 million grant to expand a model for telehealth services to help address disparities in rural areas throughout the state.
The grant, provided by the Alabama Department of Finance, will support the creation of four telehealth health and wellness centers in the Black Belt region for two years, following a model that is already in place in Chambers County.
The clinic is spearheaded by Auburn University Outreach, along with a partnership with Alabama Cooperative Extension system and other departments at Auburn University.
Hollie Cost, an assistant vice president for university outreach and public service, said in a statement the center in Chambers had touched "many lives in that community." The clinic in Chambers County had 569 visitors in the first two quarters of the year.
The locations for the four additional facilities have yet to be decided, but Cost said they will likely be placed within the Black Bet to help address the disparities in health outcomes for those areas. Planners are in the process of soliciting feedback from the communities to determine the most suitable location for the clinics.
"With all requests for funding, the Finance Department ensures that the program is an eligible use of the federal funds as well as addresses the needs of the citizens of our state," said Susan Franklin Wilhelm, assistant finance director with the Alabama Department of Finance. "This funding supports the installation and operation of telehealth stations to provide access to health care, nursing and pharmacy services related to COVID-19, maternal healt, and health services that are especially needed in our rural areas including maternal care and management of diabetes and cardiac conditions."
Health care continues to be a pressing need in rural parts of Alabama. According to the Alabama Department of Public Health, eight rural counties in the state do not have hospitals, and 16 of the state's 54 rural counties do not offer labor or delivery service.
Many hospitals in rural Alabama are not financially stable. According to a report from the Wellness Coalition published in 2018, six rural hospitals have closed since 2011 and 88% of the rural hospitals are operating with deficits.
In many instances, patients use telehealth medicine in their homes by speaking with someone on their phones, or through video conferencing through the internet, allowing them to describe their symptoms to the medical provider who will offer a diagnosis and recommend treatment.
"If there are not doctors, no hospitals, not anything in the community, and there is a way for somebody in the community to be able to get access through telehealth, then that is helpful to them," said Harold Miller, president and CEO of the Center for Healthcare Quality and Payment Reform.
The clinics represent a different model than what many currently offer, with the patient having to travel to a clinic to receive medical treatment, instead of getting seen virtually in their homes.
Chambers County's clinic has been open since March. Patients travel to the clinic and meet a staff member onsite, who guides patients through the process to be seen either by a nurse practitioner or physician assistant.
"They enter into the station, and once they do, the door shuts behind them for privacy, and a clinician will come on the screen and start talking with the patient," Cost said in an interview Monday.
The clinic setting enhances the interaction between the medical provider and the patient.
"There are diagnostic tools available that are integrated into this telehealth technology," Cost said in the interview. "There is a scale, there is a thermometer, an instrument that measures the oxygen levels, the blood pressure. There is even a stethoscope that comes down from the ceiling, and there is a high-definition camera for people who have problems with their eyes."
Access to medical records is also embedded into the system, allowing the medical provider to document the issues and record the treatment plan offered to the patient.
The physician may also prescribe medication and dispense it to the patient. That service is not permitted in the state yet but will hopefully be available soon.
"Auburn University faculty and students, who are going to be working in these communities to have some preventative care measures," Cost said of the facilities. "We will have screenings, vaccines available. We will have health and wellness education classes."
There is a speech and hearing program available in Chambers County to diagnose patients. Cost said students are traveling weekly to Chambers County to provide that service.
Internet availability, especially high-speed internet, will be critical for the model to be effective. Many rural residents struggle with having access to broadband.
That has not been a problem for the site in Chambers County, according to Cost.
"There have been, maybe, a couple of glitches," she said. "With OnMed, they do monitor those connections 24 hours a day, and they can look through and see when calls are being dropped."
Accessibility will be a major consideration in locating the additional clinics, Cost said.
"We are reaching out to the major service providers, and we want to make sure that we have appropriate connectivity or we just can't do it," she said. "If that is not available in certain locations, we just can't install it there."
(READ MORE: Policy, rural care gaps hurt Alabama women's access to health care)
Auburn University and Alabama Cooperative Extension are helping to meet the staffing needs, such as a person to greet the patient and walk them through the process of getting seen. Students at the university will be traveling to the site to provide services. Staff will also interact with the community to provide information about the clinic to ensure the clinics are meeting the needs of patients.
"The funds provided by the Alabama Department of Finance through ARPA will enable us to work toward our goal of equitable health care access across rural Alabama," said Royrickers Cook, vice president for University Outreach and associate provost. "The center we've established in Chambers County collaboratively with the Alabama Cooperative Extension System, other colleges across campus and Chambers County community members and leaders enabled us to refine a model to replicate in these underserved areas throughout the Black Belt. We are especially enthusiastic about the opportunity to partner with other universities and health care service providers to deliver high-quality health care and health education to our neighbors."
Read more at AlabamaReflector.com.