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We've Forgotten Rural Health


As a longtime Orlando resident, I'm privileged to have some of the best hospitals in the country located a $6 Uber ride away, a fact that I had never really taken stock of until recently. Through my work with Health Innovators, I've

been given a behind the scenes peek at these monolithic institutions - and been afforded the opportunity to meet and develop meaningful relationships with many of the administrators and physicians who shape and drive those hospital systems. I have intimate knowledge that myself and my neighbors are in the hands of caregivers who are not only excellently trained, but deeply motivated to improve their patients' outcomes. In other parts of the state the same cannot be said, a fact that many rural Floridians have been aware of for quite some time.

A recent family emergency put me smack dab in the middle of the rural hospital experience. I was immediately troubled by how the most simple implementations of cost effective technologies would have drastically changed not just my family's experience for the better, but the care providers' experience as well.

I knew I was in for a rocky ride from the start when the paramedics didn't have an address for the hospital. I was literally unable to use GPS navigation in a town I knew nothing about.

But it wasn't until my loved one was discharged from ICU without a diagnosis or aftercare instructions that I realized how devastating these mediocre communication practices could be to a family struggling with a health crisis.

There was a point in the ER as we were wheeling a gurney from radiology that I had to interrupt the technician and correct them as to what room we were supposed to be heading to. After a bit of back and forth, the technician laughed and said "Well, you seem to have the most up to date information, I'm listening to you!" My stomach dropped and a silly, panicked thought crept through my mind, "Toto, we're not in Orange County anymore."

Although a majority of the care providers I encountered there were personable and hardworking, I was continuously struck by their utter lack of care coordination. It was rampant at every turn. There were simple communication problems like being told the patient was receiving previously prescribed medications during respiratory therapy, only to later be told by another team member that no one had ever ordered the respiratory therapist and thus no medications had ever been administered. There were also larger endemic problems, like the attending physician telling me I needed to direct my questions to the patient and then ending the discharge conversation there. He made it very clear to me that he did not have time for me, or for that incredibly vital conversation.

This is all a symptom of something larger, a malignancy in our system stemming from an ability to be complacent. To look away. To not worry about the physicians or patients in rural hospitals because we would never go there for care. While I cleaned up a long-ignored splatter of my loved one's blood off of the ICU floor, listening to their ragged breathing as they slept, I began to think about what needed to happen to begin a forced change. Clearly Meaningful Use and HCAHPS surveys are not having the impact here that they should be.

And then I realized something.

What is there - truly - that an underfunded hospital can do? How accessible are technologies to a system that has one ICU doctor who is only contracted at the hospital for two hours a day, treating 24 ICU patients? At what point does the onus fall on us, the innovators in health technology, to begin approaching these ignored systems instead of constantly chasing the white whale of our fantasies? While I was there I met care providers and administrators who seemed just as frustrated as I was, and when my work with Health Innovators came up I found them incredibly eager to engage with technologies, they simply lacked access to them.

So, I make a call to physician entrepreneurs and other innovators in healthcare -- Reach out to Rural Hospitals! Work with them, and within their budgets, to solve simple problems we often forget still linger in some hospital systems. Research their administrators and reach out to them directly. I think you'll be surprised at how eager they are to play ball. Does the hospital not have enough to finance the project? Find grants to help fund your efforts, or reach out to your state legislature and explore what initiatives you could participate in. Perhaps even take an un-capitalistic turn and knowingly take a loss on a system, so that patients may receive a standard of care we would all hope to have access to.

We are the future of healthcare, we are what will bring about a new standard of care that we wouldn't have dreamed of ten years ago. Let's not leave behind entire populations just because they don't live in the right ZIP Code.

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