As the COVID-19 virus continues to spread, hospitals in rural North Carolina are busy treating and vaccinating patients while also addressing issues such as staffing shortages and access to specialized care.

Three regional healthcare leaders and a policy leader from the North Carolina Rural Center recently came together in a virtual town hall to discuss these and other topics affecting healthcare access and delivery in rural North Carolina.

The conversation was part of a series of virtual town halls hosted by the North Carolina Healthcare Association.

Panelists featured Brandy Bynum Dawson, Senior Director of Policy & Advocacy, NC Rural Center; Roxie Wells, MD, President, Cape Fear Valley Health – Hoke Hospital; Jonathan Snyder, MD, Chief Medical Officer at Hugh Chatham Memorial Hospital; Chuck Mantooth, President and CEO of Appalachian Regional Healthcare System, and Nisha Mehta, MD, Charlotte-based physician, speaker and writer.

Here are some of the key takeaways from the conversation:

COVID-19 treatment and vaccination in rural areas

The first wave of COVID-19 infections presented a challenge for healthcare workers because little was known about how to prevent the spread and some hospitals had shortages of PPE. Now, the delta variant is posing different challenges to treatment and prevention. Patients are arriving much more seriously ill and are hospitalized for longer, Snyder said. However, healthcare systems have been able to keep hospitalizations down using potentially life-saving antibody treatments, like Regeneron.

“The workforce is tired,” Mantooth said. “We’re here; we’re weary, but we’re still taking care of folks in western North Carolina.”

More education about the availability of these treatments and vaccinations could decrease hospitalizations even more, Wells said about her Cape Fear community. They’ve promoted COVID-19 prevention by providing about 10,000 vaccinations over 18 weeks in partnership with schools, the health department and local organizations. Dawson agreed that these kinds of grassroots partnerships are key to overcoming the virus.

Improving access to healthcare and staff shortages using technology and strategic partnerships

Healthcare access is an ongoing issue in rural North Carolina, exacerbated by staff shortages and lack of services, like behavioral healthcare. However, use of telehealth technology as well as collaborative partnerships have expanded access.

Snyder can attest to seeing great success with telehealth even before the pandemic and certainly throughout.

“What [providers] saw was amazing: Improved compliance, decreased no-show rates and better clinical outcomes, because coming into an office for that patient population was a barrier access,” he said.

Along with telehealth, he’s used strategic partnerships with the local nursing school and other medical service providers to increase access to services and solve staff shortages.

Cape Fear Valley Health has added 12 residency programs to their health system as a means of supporting medical education and addressing staff shortages. Of 30 recent graduates, 15 went on to work in rural communities.

“That has been a phenomenal way for us to retain talent in our community,” she said.

Appalachian Regional Healthcare System has strategically partnered with home health and hospice organizations to offer comfortable end-of-life care for patients and their families.

Satisfying needs of rural communities

Recognizing the unique needs of rural communities, health systems in North Carolina are finding ways to offer services outside of traditional care.

“I’ve seen health providers and systems host food banks, food clinics, farmers markets…to patients as a way to prescribe healthier eating,” Dawson said.

In Mantooth’s region in the High Country of western North Carolina, a health clinic was created to treat substance use disorder. This way local patients can get the ongoing care they need.

All of this was done through research and health systems taking a vested interest in the needs of their community.

Lowering the cost of care by addressing inequities in healthcare

Panelists also shared their solutions for lowering the cost of care, such as preventative care, government policy and tackling inequities.

Snyder said that it’s much less expensive to offer preventative care than to address complex issues that have gone unaddressed for too long.

Mantooth and Wells agree that having clear government policies with limits on cost can have significant impact on lowering the cost of care in rural communities. Wells also emphasized the significance of decreasing inequities as a means of lowering healthcare costs.

“You have to address the disparities in healthcare if we are going to adequately address the cost of healthcare— not just in dollars, but in lives as well,” she said.

Register today for our next virtual town hall, Spotlight: Addressing NC’s Mental Health Crisis, on Oct. 7.