Wadena's Telemedicine Program

Wadena is surrounded by four federally designated Health Professional Shortage Areas and three Medically Underserved Areas. Ten family practice physicians, one general surgeon and one radiologist practice in Wadena, as well as six midlevel practitioners. Wadena Medical Center, and four rural clinics in four small communities within a 25-mile radius of Wadena, provide medical services. The physicians and midlevel providers refer to St. Cloud, Fargo and the Twin Cities. The Twin City referrals are mostly for trauma and subspecialty services.

The revenue generated through telemedicine falls into two categories. First, specialists are paid for telemedicine visits in the same way they are paid for face-to-face visits. Second, the revenue generated to the patient's rural site can be looked at through an episode of care. For example, a facility fee, x-rays, scans, labs, rehab therapy (PT/OT), home health visits and swing bed fees are generated for an orthopedic patient. The revenue is generated for the rural facility when services are provided.

Equipment includes the videoconferencing system and TV monitor, a document projector, and at least one video camera. The real expense for providing telemedicine service is the ongoing dedicated T1 fiber line. Telehome monitoring uses regular telephone lines to transmit blood pressure, pulse, weight and oxygen saturation measurements.

Recently the Office of the Advancement of Telehealth awarded TCH a grant that involves changing the University of Minnesota Telemedicine Network into the Minnesota Telehealth Network. The Network plans to contract with the existing University telemedicine services and expand to additional sites in northwestern Minnesota and North Dakota affiliated with SISU and the North Region Health Alliance. Up to 22 additional sites will be added over the next three years from these affiliates. Each site will identify their specialty needs, establish specialists to provide services online, and receive equipment and training. Wadena will serve as a training site for the nurses learning to provide telehealth services. By the end of the three-year period, the Minnesota Telehealth Network will have grown to 38 Minnesota counties and eight North Dakota counties.

TCH has been involved in three Office for the Advancement of Telehealth grants with the University of Minnesota (1994, 1997, 2003) and is now the lead agency in the 2006 project. A virtually private Wide Area Network in the Wadena service area that connects seven schools, five clinics, the hospital and a long term care facility was the result of two USDA Rural Utilities Services grants received in 2000 and 2006.