Rural Project Examples Addressing Service delivery models

ADPH Telehealth Program
Updated/reviewed August 2022

Need: To increase access to healthcare throughout Alabama.
Intervention: The Alabama Department of Public Health (ADPH) has created telehealth communications at county health departments.
Results: ADPH telehealth services are currently available in 65 of 67 county health departments.

Fostering Futures in Menominee Nation
Updated/reviewed August 2022

Need: Since the late 1800's, trauma caused by historic events have greatly affected the way of life for Menominee Indians living on the Menominee Reservation. Economic, socioeconomic, behavioral health, and physical health issues have risen and are causing direct implications for Menominee youth.
Intervention: Through Fostering Futures, clinic, school, and Head Start/Early Head Start staff are trained in administering trauma-informed care and building resilience among children.
Results: Behavioral health visits at the Menominee Tribal Clinic have increased, school suspension rates have decreased, and graduation rates have improved from 60% to 94% since 2008.

Maine Critical Access Integrated Paramedics
Added August 2022

Need: With the nearest hospital more than an hour away, the local community health center in rural Jackman, Maine struggled to maintain its ability to offer 24/7 care to due to staffing and budgetary challenges.
Intervention: Critical Access Integrated Paramedics provide urgent care to patients after hours and on weekends.
Results: The Jackman Community Health Center has been able to offer round-the-clock care to clinic patients, while also increasing the level of EMS service available to the community.

Clinic for Special Children
Updated/reviewed July 2022

Need: To provide healthcare for the genetically vulnerable children and adults of the rural, uninsured Amish and Mennonite communities in southern Pennsylvania.
Intervention: A clinic that serves as a comprehensive medical practice for children and adults (primarily from the Amish and Mennonite communities) with rare, inherited, or complex disorders.
Results: In 2021, about 1,200 active patients with more than 400 unique genetic mutations were treated at the Clinic for Special Children.

Boone County Health Center Pulmonary Rehabilitation Program
Updated/reviewed June 2022

Need: Evidenced-based intervention to improve function and quality of life for patients with chronic obstructive pulmonary disease and other chronic lower respiratory conditions.
Intervention: Pulmonary rehabilitation program implementation in 1989.
Results: Compared to a national average of only about 3% of referred Medicare beneficiaries actually enrolling in pulmonary rehabilitation, 60% of the program's referred patients enroll. Averaging around 15 patients/year completing the program, a large combined cardiac and pulmonary rehabilitation maintenance population averages 8,000 visits/year.

Mobile Health Units for Opioid Use Disorder Treatment
Updated/reviewed April 2022

Need: To bring medication-assisted treatment to rural and underserved areas in Colorado.
Intervention: Six mobile health units travel to 32 counties and offer services like telehealth sessions, counseling, naloxone, and referrals to wraparound services.
Results: The units traveled more than 100,000 miles from January 2020 to January 2021.

Community Healthcare Integrated Paramedicine Program (CHIPP)
Updated/reviewed January 2022

Need: To reduce 911 use and improve older adults' health in rural Santa Cruz County, Arizona.
Intervention: Community paramedics made scheduled visits to patients and connected them to other community resources.
Results: CHIPP assisted over 150 people, and 911 calls decreased.

Generation Patient
Updated/reviewed June 2021

Need: To help young adults with chronic or rare conditions access health and educational resources and build a community of peers and advocates.
Intervention: Generation Patient summits bring together young adults with chronic medical disabilities, including chronic and rare conditions. The nonprofit organization also facilitates programming such as the Crohn's and Colitis Young Adults Network.
Results: Generation Patient facilitates about six virtual meetings per month in addition to programming around higher education, civic engagement, and more. The organization also facilitates a Virtual International Summit for young adults with chronic and rare conditions.

Tele-ICU for Veterans
Updated/reviewed June 2021

Need: To enhance care for patients in critical condition.
Intervention: Two VA facilities in Oklahoma and Ohio are connected through audiovisual equipment using smart technology in order for providers to monitor patients and consult with clinical staff at the bedside.
Results: From October 2019 to April 2021, there were 11,058 video assessments performed on ICU patients at the Oklahoma facility by tele-ICU staff. This resulted in 17,578 hours of patient care time.

Avita Health System Comprehensive Cardiology Program
Added April 2021

Need: Population health approach to decreasing area deaths from cardiovascular disease.
Intervention: A health system-level investment in level II cardiac catheterization services and the required specialized cardiology workforce.
Results: Since August 2018, the Avita Health System in north central Ohio has provided local cardiovascular services that have decreased hospital transfers, increased care coordination, and provided education and prevention activities that, with time, will impact population health cardiovascular outcomes.

Rural Project Examples: Service delivery models