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Health Center Tackles Sprawling Rural Service Area with Extensive Telehealth Push

David Mark, the CEO at One Health in Hardin, Montana, describes the health center’s service area as having more antelopes than people. “We’re beyond rural,” he said.

The service area, at more than 40,000 square miles, includes territory in both Montana and Wyoming, and boasts an average population density of only 2.6 people per square mile.

In recent years One Health (formerly known as the Bighorn Valley Health Center) expanded telehealth services to include school-based centers, offering primary care, mental health sessions and even dermatology visits. “We can do a lot more than we thought we could,” Mark said.

One Health has about 300 staff at nine clinic locations. The extensive telehealth offerings can help with staffing challenges because they allow clinic-to-clinic connections where patients can connect with providers as needed. 

The clinic-to-clinic connections are important because many local people have no broadband Internet services. And some patients need to limit the expenses involved with minute-to-minute cell phone charges.

Sarah Compton, telehealth program manager at One Health, said one key to expanding services is making the system as easy as possible to use – for both patients and providers. Training and education are important. For example, a staff member will work with a patient before their first telehealth visit to ensure they understand how the technology works. And then they will conduct a practice visit to work through any challenges before the visit with a provider.

At this point most mental health visits take place via telehealth, and a growing number of other visits are as well. The center is doing a pilot program with 11 patients who need hypertension monitoring. The patients receive a kit that includes a dedicated tablet, blood pressure cuff and weight scale, and are asked to take blood pressure readings twice daily. Results are available to both patients and providers.

Overall, telehealth connections account for almost 10 percent of One Health’s visits, and the number keeps growing, Compton said. “Ten percent feels pretty good.”