Health IT, Hospitals, Patient Engagement

A rural doctor says straight talk and a personal connection is the best engagement strategy

Rural communities have been far ahead of other regions in developing telemedicine tools, which have […]

Rural communities have been far ahead of other regions in developing telemedicine tools, which have helped reduce the divide between patient homes and distant hospitals for follow-up care between appointments and to assess whether they need to come in for treatment.

The Center for Rural Health Innovation led by Dr Steve North in Spruce Pine, North Carolina, is closing that gap too. Its  program, MY Health-e-Schools — is a school-based telemedicine program to improve healthcare access to students in two counties in western North Carolina. The program is designed to get students primary care without having to miss school. It collaborates with primary care physicians to provide services, such as treating ear aches or stomach aches, chronic disease management, medication management, well-child check-ups, sports physicals, adolescent medicine consultations, and telepsychology.

The Homegrown Healthcare project is designed to develop rural heath care providers from the region to help address the overall shortage of nurses and physicians.

North is taking part in a panel at the upcoming ENGAGE conference that will talk about how technology is being used to improve access to healthcare for tough-to-reach patients.

What is the biggest challenge you and other providers face when trying to help patients with chronic illnesses? In rural areas, it is really hard to bring support services together. For example, it’s hard to get nutritionists engaged with patients. There’s a program — the Church Health Center in Memphis, Tennessee. It  provides support services for uninsured and low-income Tennessee residents. [It has a wellness center that offers health education classes, including nutrition counseling. A nutritionist helps people shop for food and make things they are likely to eat and teaches them how to make these dishes healthier.] When people are fighting for basic necessities, it’s often tough for them to focus on their own health. It’s a lot faster and cheaper to grab a burger at a fast food joint or convenience store. We may not always have the slots to see people as often as we’d want. For people with chronic pain, we can’t provide access to alternative remedies such as Tai Chi.

What is the best patient engagement tool you’ve seen?
I think the best patient engagement is a bit of candor. As a person I wrestle with the dilemma of quick food and healthy food. I am tall but I’m not built like a basketball player. When I communicate that to patients it makes it more like a conversation rather than a list of things they need to do.

What’s the right combination of high tech and high touch for patient engagement?

You have to have high touch first, you have to have a relationship with patients before they are willing to try the next step.

What’s an example of something you changed about your practice based on what patients wanted?

I changed from sending letters to phone calls for lab results so patients could ask me questions while I was on the phone with them. So we could have a conversation that goes beyond — your cholesterol was this, so you need to do this.

Who inspires you?
Joy Dryfoos, who pioneered school-based health centers. And my dad. Seeing him practice medicine — outside the clinic in the church and the parlor — he always felt like he was on call.

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