In the town of Terre Haute, near Indiana State University (yes, where Larry Bird played basketball) a noble experiment in healthcare innovation is taking place. The Lugar Center for Rural Healthcare is redefining how a Family Medicine Residency Program, a Teaching Hospital (Union Hospital), a Medical School (Indiana University School of Medicine), and a Community (Indiana AHEC) can work together to innovate and develop a sustainable and reproducible model for rural health care.
Their mission, "to prepare and train primary care physicians for successful rural practice," is needed more today than ever before. As the nation confronts the stark realities of a growing primary care shortage, the Lugar Center is focused on using technology and innovative practices to improve medical access for patients and resources for physicians.
The Lugar Center has adopted two core principles to deliver more effective rural health care:
1 - The rural clinics they set up and maintain are designed to provide the physicians who run them with ancillary support as needed. Each clinic has a physician, a midlevel provider, a social worker, and a mental health provider. This allows the physician to focus on patient care while the support staff tackle specific issues like transportation or social support for the patients. While there is nothing new about a multidisciplinary team, the implementation in a rural area, under the same roof, and employed by the practice is creative - especially while the cllinic maintains a positive cash flow.
2 - Lugar regularly evaluates new solutions and trains their physicians to use technology to overcome issues that arise from isolation. They have initiatives in Telemedicine, Online Consults, and Chronic Disease Management. Mental health is an issue that is particularly time sensitive. By providing a telemedicine link between a critical access Emergency Room and a group of mental health professionals, 24/7, they were able to decrease length of time in the ER, arrange for more appropriate follow up care, and reduce the strain on physician and staff.
As the Lugar Center redefines rural medicine throughout Indiana, they have also recognized that their model can be replicated worldwide and currently work with sites in Kenya to implement rural health care centers.
In these challenging times, the Lugar Center for Rural Health, and its partners are innovators we can be proud of. I will be following their progress closely as they continue to develop new programs and ideas aimed at improving healthcare around the world.
Jason Bhan, MD