Virtual doctors are helping Piggott Health System with real growth.
The Health System, which features a 25-bed hospital, is able to keep more of its patients in its network thanks to using telemedicine for pulmonology, cardiology and infectious disease services, said James Magee, executive director of the system.
And on Wednesday, it is scheduled to add a neurology program to its portfolio of telemedicine services.
That additional service is expected to increase revenue because it will also require other services such as MRI scans and other procedures, Magee said.
The virtual doctors are being provided by Access TeleCare of Dallas, which started working with Piggott Health System about four years ago. Magee said the company’s services helped the hospital survive at a time when some hospitals — especially small, rural ones — are struggling.
“I’m not saying we wouldn’t survive without that,” he said. “But it certainly is an enhancement, not only for the care, but it’s also financially helpful in that we have a higher census.”
He said more than 100 initial consultations a month involve the telehealth specialists, “and that’s not counting the follow-up consults.”
The Health System’s goal has been to increase its patient census by keeping higher acuity patients than it normally would have kept.
A few years ago, Piggott’s hospital reported about 3,500 visits a year to its emergency room. Last year that number was about 7,000. As a result of the telemedicine program, the hospital has been transferring fewer patients in recent years. It now transfers between 35 and 50 patients a month.
Hospitals rely on their census and their admissions to keep operating. “And so when they send patients away, they’re losing part of that business,” said Access TeleCare’s CEO, Dr. Chris Gallagher, who is a cardiologist by training. “And that’s vital for them to stay operational.”
But Piggott Health System is still struggling financially.
It reported $23.57 million in net patient revenue for 2022 and a loss of $2.35 million. Magee said the audited financials for 2023 aren’t complete, but the system will experience a loss.
Piggott Health System |
|||||
| 2022 | 2021 | 2020 | 2019 | 2018 | |
| Net patient revenue | $23,566,440 | $22,281,899 | NA | $20,501,576 | $17,486,382 |
| Net income | -$2,354,577 | $2,785,769 | NA | -$884,915 | $125,947 |
Fiscal year ended Dec. 31 (Source: Medicare cost reports (most unaudited) filed with the Centers for Medicare & Medicaid Services. Audited and unaudited net income may differ substantially because hospitals subtract recoverable costs not recognized by Medicare from operating expenses before deriving final net income.)
“Health care is not easy,” said Magee, who has headed Piggott Health for nearly 27 years. “I don’t think I’ve ever experienced it any tougher than it is right now.”
Piggott Health System has expanded in other areas to improve its financial condition.
On July 1, it opened a 1,400-SF expansion of its behavioral health unit. The intensive outpatient therapy program primarily targets the elderly who are depressed or who’ve had a major life change, Magee said.
It also is expanding its home health program, which Magee said is profitable. It’s scheduled to open a branch office of its Missouri home health agency in Kennett on Oct. 1. “We think that we can eventually double the size of our Missouri Home Health operation,” Magee said.
It has two home health agencies, one in Piggott and one just across the Missouri state line in Dunklin County.
Piggott Health System recently reported having 212 patients in its home health program.
But its telehealth program also will fuel the health provider’s growth.
Joining Piggott
About four years ago, Access TeleCare began meeting with Piggott Health System executives to describe how telemedicine could help them keep patients in their community, said Access TeleCare’s Gallagher.
Access has been providing services to Arkansas hospitals for about 10 years. It has about 2,300 programs across the country and serves just under 20% of U.S. hospitals, Gallagher said.
“Telemedicine is solving the specialty access need, which enables the hospital to keep patients local to receive their complex care,” Gallagher said.
At the time of the meeting with Access TeleCare, Piggott had been dabbling with telehealth since about 2016. But that service had “some major drawbacks,” including the virtual specialist having to be in another hospital’s studio to visit the patient in Piggott.
Piggott faced the same problem as other hospitals. Patients who needed a specialist would have to be transferred to another hospital because there wasn’t one available.
Gallagher told Piggott that its “biggest opportunity” was with critical care and pulmonary medicine.
“So we built a pulmonary critical care program,” he said. “And once we got that started, then we moved on to a cardiology program to make sure that they were keeping those patients. And then expanding to infectious disease to manage patients with complex infectious problems as well.”
How It Works
Access TeleCare’s specialists are all licensed Arkansas physicians and interview patients and review the electronic medical records. “And then they’re giving orders which are carried out by nurses, therapists or pharmacists,” Gallagher said. “Most of the work is carried out by those staff that were in the hospital, whether we were standing there in person or not.”
Access TeleCare also uses a 6-foot telemedicine cart that has a 24-inch screen with built-in microphones and speakers.
The cart also has a camera that can zoom in and evaluate the patient. “And we also have a digital stethoscope on the cart, so we can do an exam, listen to their heart, listen to their lungs,” Gallagher said.
He said that it’s fulfilling to know that his company is helping to manage patients that otherwise wouldn’t receive care or have to travel to receive care.
The Access TeleCare doctors bill the patients through their own insurance or government payers, “just like when you go in person to see a doctor,” he said.
The hospital also bills the patient for its services.
Magee said that he didn’t realize how well telemedicine would be embraced by patients and their families.
“We’re a rural community, and like most rural communities, we have a lot of senior citizen patients,” Magee said. “I was surprised at how readily not only seniors, but all ages, accepted telemedicine and have been very complimentary of the service.”
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