Essentia Health, an integrated health care delivery system based in Duluth, Minn., provides telehealth services to patients at 26 of its roughly 80 rural health clinics, small rural hospitals and long-term care facilities in Minnesota, North Dakota, Wisconsin and Iowa. Its goal is to provide telehealth services that link all of its small rural health facilities to its larger urban hospitals so patients can get care in their own communities and not be forced to drive three hours or more to see a specialist in a big city hospital.

The system has moved closer to that goal, thanks to a U.S. Department of Agriculture (USDA) grant, which it received last month. The $213,560 grant will help the system extend telehealth to 21 more rural sites and provide more telehealth equipment at three of its highest-volume clinics.   

Under Essentia Health’s telehealth program, high-resolution cameras, microphones and a secure network connection allow patients in rurally isolated communities to interact in real time with a long-distance doctor in more than 20 different specialties, including allergy, behavioral health, chronic pain management, dermatology, dietician services, infectious disease, medical weight loss, medication therapy management, rehab therapy, urology and wound care.  

The rural clinic has a rolling cart with a video monitor and camera that can be wheeled right up to the patient’s bedside. A hand-held camera allows for up-close looks at a patient’s anatomy. A stethoscope connects to a computer allowing a specialist at one of Essentia Health’s urban hospitals to listen to a patient’s heart beat or breathing, and talk to the local caregiver and patient as if they were in the same room.

“Patients feel like the specialists are part of the medical staff in their home towns,” says Maureen Idecker, Essentia Health’s telehealth director.  “We see a high volume of satisfaction among both patients and specialists.”     

Beginning this month, she says Essential Health is using the USDA grant to purchase state-of-the-art videoconferencing carts, camera, stethoscopes and ear scopes used for telehealth visits and exams at the clinics.

As a recent AHA TrendWatch report noted, telehealth holds great promise for improving care because it offers such benefits as virtual consultations with specialists, the ability to perform high-tech monitoring at home or in their community, and less expensive and more convenient care options for patients. And the report says telehealth can be especially helpful in improving access to care and convenience for patients in rural areas. For the report, visit the “Research & Trends” section of

But the report – and a subsequent AHA letter to congressional health care leaders drafting telehealth legislation (see story on this page) – also criticized Medicare for lagging behind the private sector and many state Medicaid programs in promoting telehealth.  Essentia Health’s Idecker shares some of those concerns. She says telehealth’s growth could be impeded by narrow practitioner eligibility requirements.        

Ideker suggests Medicare expand the list of telehealth practitioners eligible for payment to include pharmacists, audiologists, speech language pathologists, physical therapists and occupational therapists, and certified diabetic educators. “What we don’t see in the current coverage under Medicare is a wide enough list of eligible providers,” she says.  “The policy needs to be updated.”

All the same, Idecker says Essentia Health is committed to expanding telehealth services to its communities to keep rural health care strong. “People in rural America are great people to work with and to serve,” she says. “We’re committed to ensuring that people in rural settings have the same access to care as those in metropolitan areas where the specialists reside.”  


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