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Rural Health Information Hub

Regional Obstetrical Consultants

  • Project Title: Solutions to Obstetrics in Rural Counties (STORC)
  • Synopsis: Chattanooga's STORC program increases prenatal services for high-risk pregnancies in rural communities.
  • Program Representative Interviewed: Josie Compton, Clinical Director
  • Location: Chattanooga, TN
  • Program Overview: STORC is an arm of Regional Obstetrical Consultants (ROC), based in Chattanooga, Tennessee. Developed in 2008, the goal of STORC is to provide specialist care in rural communities so that high-risk pregnant mothers are able to receive prenatal care and give birth in their local communities. STORC operates under the belief that when mothers receive necessary intervention early, local doctors can manage many high-risk conditions in pregnancy. To this end, expectant mothers receive general prenatal care from their local providers and STORC provides high-tech, high-touch complementary care. A sonographer and advanced practice care provider travel to rural communities and provide in-person care while mothers receive telehealthcare from physicians specializing in maternal fetal medicine located in Chattanooga. STORC personnel travel with all necessary equipment to deliver care.

    STORC currently serves 11 rural sites in Tennessee and Georgia. Practitioners visit two to three rural clinics every day and 50,000 visits have been conducted to date. The furthest clinic served by STORC is 100 miles from Chattanooga. While originally based on the UAMS IDHI High-Risk Pregnancy Program (formerly the ANGELS model), STORC has made considerable alterations and innovations, becoming its own replicable model. UAMS IDHI High-Risk Pregnancy Program founder Dr. Curtis Lowery and his team were genuine partners in assisting with implementation.

    In 2018, 90% of women with high-risk pregnancies who received care from STORC gave birth in their local hospital. 81% of pregnancies were carried to 37 weeks or longer, and only 11% of infants required care administered in the Neonatal Intensive Care Unit. This is in a setting of only high-risk referred patients.

    Considerations for implementing a model such as STORC include:
    • Having a reliable broadband network through which telehealth can be administered. Additionally, if services are provided across state lines, the telehealth network will need to expand to include interstate providers. This process can be cumbersome, as each state has unique processes in place for joining networks.
    • Having buy-in from the local hospital is necessary, as local care providers will be working with STORC providers and use of the lab may be necessary.
    • IT support from STORC will need to work with IT from the local clinic or hospital to set up a HIPAA-compliant VPN network, allowing for telehealth services and medical records to be shared.
    • Office and clinical space are necessary to provide care in the rural communities. This space may be located at the hospital or clinic or it may be located in an entirely different facility.
    • Insurance company recruitment to join the telehealth network. This may be a challenge, as this type of complementary care is not a well-known service. Having a champion in the sales department can help.

A May 2018 podcast recording from Blue Cross Blue Shield, Using Telemedicine to Improve Rural Women's Health and Save Babies' Lives, provides more information on STORC.

Read about the UAMS IDHI High-Risk Pregnancy Program (the model upon which STORC is built) in RHIhub's Rural Health Models and Innovations.

Models represented by this program: