Eric Wallace, M.D., UAB medical director of Telehealth and associate professor in the Division of Nephrology, was recently nominated and selected as the 2021 Community Star of Alabama by the National Organization of State Offices of Rural Health (NOSORH).
NOSORH celebrates National Rural Health Day this year on Nov. 18. The annual event seeks to raise awareness of rural health and to honor experts who are making exceptional contributions to the field. It is an opportunity to celebrate the power of rural areas by honoring community-minded spirits in the U.S. An award is presented to one Community Star in each state every year.
Reshaping the landscape of rural care
Telehealth efforts across Alabama have greatly expanded in the past three years, reforming rural health care into a system that can provide both basic and subspecialty care to all Alabamians.
For decades, a great need has existed in Alabama to deliver critical care and subspecialty care in rural areas. Physician offices and hospitals in those areas have not had the financial resources or staffing bandwidth needed to provide specialty care.
Until recently, patients in need of nephrology, infectious disease, critical care, and neurology services—among others—would be transferred to UAB, or another large hospital in a metro city, to receive inpatient or outpatient care. The burden of such travel has been equally weighted on the hospital system and on the patient and their families.
Wallace identified these issues years ago, and in 2016, he became the first physician in the country to replace a comprehensive, in-person doctor/patient visit with a telehealth visit for home dialysis.
The successful first-of-its-kind appointment led to the creation of a secondary line of service, one that would create access to subspecialty care for thousands of Alabamians in rural areas.
Now, because of Wallace’s and his team’s telehealth efforts, along with several partnerships they have made along the way, the field of telehealth is headed in an innovative direction where the rural facility becomes a center capable of delivering subspecialized care so that specialty and emergency health care can be given to the patient within miles of their home.
Expanding efforts across the state
Because of UAB’s massive efforts in telehealth, Wallace and his teams have been able to engage three other hospitals in telenephrology in Alabama to partner on helping patients from rural areas, and 14 other hospitals for telehealth.
As an example, a rural patient with kidney disease can access a subspecialty physician via tele-visit, where the specialist can look at their labs, charts, and history. If the patient needs dialysis, then technicians in the area go to the hospital to provide dialysis. The process is similar for infectious disease and neurology patients, as well as critical care patients. If a patient needs to be intubated, the specialty doctor will assist with high risk ventilator management to the on-site team.
To care for one single patient, large units of health care providers, researchers, administration teams, and other health care staff are required to make telehealth options available. “We’ve managed to put subspecialties into areas that had none,” Wallace said. This effort has required dozens of partnerships and networking, creating a telehealth system that asks teams from multiple institutions, organizations, and hospitals to work together. “Building the relationships between doctors externally has been one of the most beneficial parts of our telehealth efforts,” he explained. “We can do a lot more together than we can do apart.”
Removing barriers to provide equitable care
Wallace said that telehealth lessens the seclusion of private practitioners in rural areas who may have limited resources. Plus, the telehealth model connects primary care physicians with subspecialists at UAB and other large hospitals to share knowledge. The subspecialists inform and apprise primary physicians of subspecialty diseases, new discoveries, and therapeutics. Plus, Wallace explained that “Partnering with rural doctors, can also increase the rate of dissemination of knowledge bringing the cutting edge to everywhere faster.” Wallace said that a faster pace of knowledge-sharing can quickly tear down barriers to accessing specialty care.
In addition to the lack of resources for rural physicians, a major contributor to health disparities in the state is patient access to care. The amount of time, money, and resources it takes to travel to and from large metro cities to receive care is a heavy burden. Wallace said if patients can receive care in their own community, it could save lives, improve quality of life, and raise the bar for health care across the state. “We could turn Alabama into a model for equitable state-wide health care,” he said.
Telehealth work has just begun
“This Community Star award has taken thousands of people,” Wallace said. “It shows how we can all work together. There is enough people and interest in Alabama and rural areas that care to make this work. Telehealth has been years in the making...and is an attestation to Alabama’s goals.”
Wallace said he sees telehealth already helping Alabamians and their physicians in a major way, but explains there is so much more work to be done. “If we can make such giant strides in such little time, where will we be in another year and a half?”
Celebrate National Rural Health Day
Join NOSORH and their event on National Rural Health Day to honor each 2021 Community Star in all 50 states virtually. This year’s theme is “The Power of Rural: Resiliency, Resolve, Relationships, and Readiness.” Over the past decade, National Rural Health Day has transformed from a one-day event to a sustainable movement that engages health care workers, policymakers, community partners, and more. On Nov. 18 at 1 p.m. CST, the National Rural Health Day live event will introduce audiences to all 50 Community Stars, including Wallace. Join the interactive celebration.