RuralConsult.com is an outreach telemedicine initiative developed by the Richard G. Lugar Center for Rural Health (formerly Midwest Center for Rural Health or MCRH). Development of RuralConsult.comä was a direct result of difficulties encountered by rural patients and providers to access specialty services in their rural communities. These difficulties are exacerbated by a high proportion of elderly and low-income patients who often face transportation barriers in traveling to distant sites to receive care.

RuralConsult.com is a store-and-forward telemedicine technology that addresses medical provider shortages and lack of access to specialty information and services in rural areas. This platform provides for non-emergency consultations in many specialty areas. These currently include: dermatology (2 specialists), neurology, endocrinology, gastroenterology, pediatrics, geriatrics, clinical toxicology, obstetrics and gynecology, and HIV. RuralConsult.com has been in use since June 1999, and more than 300 Hoosiers have gained access to specialty care via the RuralConsult.com system.

Generous grant funding has enabled us to educate users about the availability of the system as well as provide ongoing enhancements and user-support, thus enabling the Lugar Center to expand the system. The Richard G. Lugar Center for Rural Health is very excited about the recent addition of its first international user from Ghana, Africa. Dr. Komli-Kofi Atsina of Atsina Charity medical clinic was added to the system on July 22, 2004. Dr. Atsina completed his first consult on August 2, 2004. If you are a provider interested in participating in telemedicine please contact the Lugar Center for more details.
Click here to browse a demo of the RuralConsult site.

The Richard G. Lugar Center for Rural Health firmly believes that at every level of patient care, hands-on experience is the best teacher. The Human Patient Simulator (HPS), which is a computer-model-driven and full-sized mannequin, delivers that experience in true-to-life scenarios that swiftly change to meet instructors’ goals. The ultra sophisticated and highly versatile HPS blinks, speaks and breathes, has a heartbeat and a pulse, and accurately mirrors human responses to such procedures as CPR, intravenous medication, intubation, ventilation, and catheterization. How is this possible? Through a painstaking marriage of “high touch” with “high tech,” this dramatically functional mannequin exhibits clinical signals extremely lifelike and can also "die". Add to this a profound array of intricately programmed systems – cardiovascular, pulmonary, pharmacological, metabolic, genitourinary (male and female), and neurological – and you have an easily controlled teaching laboratory where students can practice again and again, until the highest-quality patient care becomes second nature. The Lugar Center is excited to put this new teaching tool in effect.

Residents of Clinton Indiana have now access to emergent mental health evaluations at West Central Community Hospital. As a result of a generous grant from the State Office of Rural Health, Union Hospital's Richard G. Lugar Center for Rural Health has partnered with Hamilton Center, a Community Mental Health Center, to setup a telemedicine outreach program to a Critical Access Hospital (CAH).

Patients presenting at West Central Community Hospital's emergency room (ER) with an emergent mental health need will be connected with a trained mental healthcare provider on staff at Hamilton Center via an advanced live telemedicine link. Lugar Center began researching the need for the system in mid 2006 when staff learned that multiple contracts for service between Hamilton Center and West Central had failed due to issues with distance, difficult travel, varying demand, and inconvenient hours of need. A recent study of 422 CAH's across 44 states, completed by The Main Rural Health Research Center, found that nearly 10% of all CAH ER visits were mental health related. The study also concluded that patients presenting with suicidal symptoms represent 2% of all CAH ER visits. The project hopes to avoid costly hospital admissions and transfers while keeping stressed patients close to their loved ones.

"The information technology revolution holds tremendous potential for addressing healthcare issues in rural areas," said Hicham Rahmouni, IT specialist at The Lugar Center, who was instrumental in acquiring the funding. The Lugar Center will collaborate with The State Office of Rural Health, Hamilton Center, Greg Beck, and Dr. Jonathan Neufeld to complete a thorough project evaluation. Findings from the project will be shared with internal and external project stakeholders and others around the state in hopes of programmatic expansion. The group also plans to work with payers around the state to urge them to consider adopting reimbursement policies that support the use of telemedicine technology. Additionally, the Lugar Center has included the Vigo County Jail as an originating site for the outreach program. The site was included to assist the network in addressing issues around network sustainability. The payment structure and policies for the jail are more established and there are fewer roadblocks to getting reimbursed for services rendered. Dr. James Turner D.O., Director of the Richard G. Lugar Center for Rural Health, and a family medicine practitioner who specializes in addictions and correctional medicine stated, "It is very common to need mental health consults and emergent suicide evaluations at the jail as well as in family medicine clinics. I cannot stress enough how important it is for our residents to have some exposure to this population and emerging technology. Inmates seek care at my clinic on a regular basis simply because we are the closest facility. I would have appreciated having a little preparation in residency prior to that first inmate encounter." The Lugar Center hopes to partner with the jail to utilize the system for additional purposes such as tele-arraignment and education. We are extremely excited about this project and the impact it will have on Terre Haute and surrounding communities.

The Union Hospital-Lugar Center Live Telemedicine Program was recently featured in an article published by the National Rural Health Association's RuralRoads Magazine. The article: "Telemedicine Activity in Indiana Gets a Boost" was published in the December 2007 issue of the publication. Click here to learn more.