The University of Iowa Hospitals & Clinics works with Van Buren County Hospital for its new virtual hospitalist service.
By Jenna Larson
Being the first known virtual hospital service in the state, the University of Iowa Hospitals & Clinics and Van Buren County Hospital launched its service in November last year. They have recently announced the program to the public.
“The need for the virtual hospitalist service is twofold,” said Kate Klefstad, the digital health service line manager at the Signal Center for Health Innovation. “It comes from the outside, and it also comes from the inside.”
The outside component of the service is the Van Buren County Hospital, and the inside component is the technology and resources, she said.
“I was hearing from my critical access hospital partners that they needed more resources from the University of Iowa and were open to fulfilling that need in innovative ways,” Klefstad said.
Van Buren officials knew that experts from UIHC could not be sent every day, she said. The idea of telemedicine seemed to be the best option for UIHC to communicate with Van Buren on a daily basis.
“They are willing to try new things and learn with us,” Klefstad said.
A specific issue that Van Buren wanted to solve was communicating with UIHC and patients on whether being transported to UIHC was necessary.
“They had this need for a service that would help them keep patients closer to home,” she said.
In order to ensure UIHC’s resources were going further and reaching more people, Klefstad and her team worked with their hospitalist team.
“It really is better for everyone involved if we keep [patients] in their communities with good support from the University of Iowa,” she said.
As for Van Buren County Hospital, a lot of work was done on its side with UIHC to ensure the service was ready.
“We had to do a lot of coordination and ourselves and the university to make sure that everybody was aware of what the plan was,” said Rhonda Fellows, chief nursing officer at the Van Buren facility.
Planning and preparation was done at the county hospital through weekly meetings in order to have everything set up as they anticipated their starting date, Fellows said.
“What happens [with the virtual hospitalist service] is that twice a day, our provider here [is] in a virtual room with the eHospitalist with the [university],” she said.
The charge nurses look at the patients’ charts with the UIHC specialists via iPad, where they then take the iPad and make rounds to see the patients.
“We obviously want patients that are able to stay close to home longer,” she said. “If they do need to be transferred, we are able to plan that transfer in a fashion that is more controlled.”
Having this service helps with continuity care, she said. It also adds to learning on Van Buren’s end and impatient care with being able to have another set of eyes from the UIHC.
“There is a tremendous shortage of specialized hospital medicine providers,” said Ethan Kuperman, a UI clinical assistant professor of internal medicine. “We were looking for a way to extend the reach of our hospital hospitalists group into the rural areas of Iowa.”
Otherwise, these patients were arriving to Iowa City causing to delays in care and separated patients from their home and support system, he said.
“We were hoping that we could provide that same degree of specialized medical care that you’d get in Iowa City [to] Keosauqua in Van Buren County Hospital,” Kuperman said.
Since November, benefits of the service are that patients can be provided good medical care through telemedicine and those that are moved to UIHC have a smooth and coordinated transportation.
“We would like to expand in two ways,” Kuperman said. “First, we think there are a lot of other specialties in medicine that could benefit from a similar approach.”
Kuperman and his team are looking to expand the services offered to include assistance from our pharmacists and infectious disease doctors.
“[Second], we have been very well-received by patients and providers at Van Buren,” he said. “We are looking to expand our reach into other rural hospitals in the state of Iowa in the coming 12 months.”
