Due to variables such as distance, weather, or lack of
provider availability, rural long-term care facilities
and their staff are challenged with meeting the clinical
needs of their residents, most with multiple chronic
Time becomes of concern for providers traveling from
clinic to clinic over long distances in order to treat a
resident with an urgent or complex health issue.
Additionally for long-term care residents themselves,
transferring out of their home environment to another
setting with other providers causes discomfort and
disorientation that further complicates their condition.
To address this, Avera
Sacred Heart Hospital, along with four Avera
affiliates and two consortium partners, developed the SD
eResidential Facilities Healthcare Services Access
This 2012 project was originally based on practice models
and studies of eLongTerm Care (eLTC)
endorsed by the American Telemedicine
Association. The intent of the eLTC program
was to assist rural long-term care facilities with better
24-hour access to needed care and urgent care support.
Staff training and education and other geriatric services
were also included.
Avera and its partners implemented the project at 20
sites located in South Dakota, Iowa, Minnesota, and
Nebraska. Participant facilities in this program were
chosen by criteria which included rural status,
healthcare access needs, urgent care needs, and nursing
The original project's population included frail elders
in long-term care, assisted living, and rehabilitation
facilities since elderly residents have higher rates of
mortality associated with chronic diseases, such as
diabetes, heart disease, and Alzheimer's Disease. At the
time, project site residents were also noted to be older
than state and national averages.
The eLTC program was gradually and
systematically implemented over three years in order to
assure quality services. Through the use of two-way
video, a specialized stethoscope, a camera used for
close-up details, and other peripheral equipment, the
eResidential project kept residents in their own
facility with the caregivers who know them best and who
were best able to provide their care. Project services
also provided site staff and caregivers with specialized
sources of medical information.
The eLTC strategies decreased healthcare cost by
avoiding unnecessary emergency room visits and hospital
The consortium partners of the SD eResidential
Facilities Healthcare Services Access Project included:
The program received support from a
2012-2015 Federal Office of Rural Health Policy Rural
Health Care Services Outreach grant.