For many, getting started in providing telehealth can seem like a daunting process - something reserved for large health systems with many resources. But with creative and willing providers, partnerships, plus some help from HTRC, providing telehealth care with limited resources can become a reality. The following is the story of a telehealth success in Kansas.
After working in rural Kansas communities throughout her career Kathy Kimpler, P.A, recognized the challenges patients in rural Kansas had with getting the cardiac care they needed and was determined to do something about it. She contacted Hossein Amirani, M.D., an interventional cardiologist with a private practice in Wichita. Amirani was interested in working together to reach out to rural communities to make it easier for patients to get the cardiology support they needed.
“Our main goal was to help people in rural communities who have a harder time getting in to see a cardiologist in a timely manner,” said Kimpler.
That is when HTRC entered the picture. Kimpler contacted HTRC Project Director Janine Gracy to find out whether HTRC was aware of any communities looking for assistance.
“I reached out to Janine at HTRC and said ‘Dr. Amirani and I are interested in telehealth - do you know anyone in need of cardiology support?’ and she said ‘I sure do!’”
Gracy then connected Kimpler and Amirani to James McDermott, D.O. and Shirley Black, a nurse practitioner at Tallgrass Rural Health Clinic in Sedan, Kan., where they had recently lost their cardiology support.
Working closely together, and with support from Gracy, Black and Kimpler started a monthly cardiology clinic. They have seen patients with a wide range of complaints, from shortness of breath to aortic regurgitation in a valve replacement patient.
Keeping it local
When patients need procedures, the team first looks to Sedan City Hospital, the local critical access hospital.
“Patients feel more conformable having procedures in their own communities, with providers they know…Shirley presents patients and I make a determination whether the patient testing can be done in Sedan hospital, which is what we really try to do. We know that these critical access hospitals need support as well, so anytime I can obtain a study or a lab at Sedan Hospital, I happily set it up there,” said Kimpler, who estimated that about two thirds of the testing and labs have been done locally.
Continuity of care
The partnership has also worked to address continuity of care - Kimpler maintains close communication with local providers. After seeing a patient, she makes a note and sends it immediately to the local primary care provider (PCP) to keep him or her informed.
“If I need to talk directly to the PCP, I have done that to give them an idea of what we plan to do, answer any questions they may have. We want the local rural medical community to know we are there for them.”
In-person connections
Kimpler and Amirani are working to expand to other communities and have established a new partnership with South Central Kansas Medical Center in Arkansas City, Kan. The new partnership seeks to add “spontaneous” services so that Amirani and other cardiologist colleagues can cover visits on short notice. They are also planning hospital consults there. In setting up the new partnership, she and Amirani have learned that even though the service will be via telehealth, it is vital to do an in-person introductory meeting with providers in the local hospital and clinics to help them feel confident in referring patients to Amirani via telehealth.
Customized assistance from HTRC
Kimpler said her partnership with HTRC has been invaluable. She has received hands-on help from HTRC – connecting needs with services, helping to explain to providers how the connection will work and assisting with regulatory and reimbursement issues. Lastly, HTRC has helped find low-cost solutions.
“I would encourage other PAs to reach out to HTRC to see what your options are, to see how you can do it on a dime," said Kimpler. "With HTRC's help, we have been able to find a way to do telehealth at a low cost for everyone.”
For assistance with your telehealth project, contact HTRC at 877-643-HTRC.
