Auburn University Rural Health Initiative

Description

In October 2020, Auburn University Outreach began developing the Rural Health Initiative to address significant health disparities across rural Alabama. Created in partnership with the Alabama Cooperative Extension System and the Colleges of Pharmacy, Nursing, and Human Sciences, the Rural Health Initiative model integrates telehealth technology with academic outreach programs and coordinated public/private partnerships while attending to critical patient-centric factors.

The City of LaFayette in Chambers County was selected as the pilot site based on significant health needs coupled with the community's capacity and desire to serve their citizens' healthcare needs. LaFayette is 24 miles from the nearest emergency room and home to a population with high rates of obesity, hypertension, and diabetes.

The Chambers County Community Health and Wellness Center, established in 2023, is housed in a previously vacated and newly renovated health clinic owned by the city. The Center includes a telehealth care station and space for pop-up clinics and outreach events offered by Auburn University faculty and students. In the early implementation stage of this initiative, Auburn University Speech, Language and Hearing Sciences joined the team, installing an audiology booth for their faculty and students to provide speech, language and hearing screenings and services for community members.

Services offered

The telehealth care station connects residents via video call to primary care services provided by clinicians licensed in Alabama. During a visit, clinicians may direct patients in the use of various diagnostic tools, such as an automated blood pressure cuff, stethoscope, and a hand-held camera. Information from these tools is shared with clinicians in real time to assist with diagnosis and prescribing.

In addition to the telehealth care station, the Auburn University Rural Health Initiative partners with Auburn faculty and students to provide weekly hearing screenings, weekly blood pressure screenings, monthly speech screenings, two interprofessional education days per semester, vaccine clinics, medication management, a community garden, nutrition education, and a small food pantry.

The Rural Health Initiative also offers a fellowship for undergraduate and graduate students with an interest in rural health.

Results

Between April 2023 and April 2024, clinicians in the telehealth station conducted 592 patient consultations and wrote 720 prescriptions. Patients' and program participants' survey results indicate overwhelming satisfaction with their experiences at the center. As of April 2024, a total of 190 faculty, staff and students have participated in center activities; a total of 560 individuals have participated in community engagement activities offered through the center. Over the past year, the Rural Health Initiative leadership team has secured just under $3 million to develop similar models in counties throughout Central Alabama based on the outcomes in Chambers County.

Ear, nose, and throat visits were the most frequently treated conditions followed by respiratory conditions. Oral, ocular, and cardiac events were the least frequently seen conditions. Antibiotics were the most frequently prescribed medication, followed by cough medications and oral steroids.

Data indicate a significant increase in station usage throughout the year. By October of 2023, the telehealth care station was averaging over 80 visits per month. The Rural Health Initiative team attributes this to extensive community outreach. For example, center staff developed a Health Ambassadors program, comprised of volunteers who promote healthy habits as well as the activities of the center.

The Rural Health Initiative team continues to cultivate university involvement with the clinic to expand the scope of services offered to the community, enhance the education of university students, and provide faculty with impactful opportunities for outreach and engagement.

The Rural Health Initiative has plans to install telehealth services in 13 additional rural communities across the state through telehealth carts as well as additional care stations. They also hope to expand services to include mental health and substance use disorder treatment via telehealth. Program leadership estimate that, once active, these telehealth services will expand healthcare access to over 53,000 rural Alabamians.

Survey Data

• 97% of participants indicated health needs were met very well or well
• 95% agreed or strongly agreed that the station was easy to use
• 95% agreed or strongly agreed that the telehealth tools that they used worked well
• 94% of participants are somewhat likely or extremely likely to recommend the service to a friend

Selected Media Coverage

• With Its Two Doctors Planning to Retire, an Alabama Town Patches Together Health Care Options, KFF Health News
• LaFayette OnMed Station is Busiest in Country, The Valley Times-News
• Auburn University Partnering With Chambers Co. to Increase Affordable Health Care, WTVM
• LaFayette Residents Finding OnMed Telehealth Station a Great Option in Health Care, Alabama Cooperative Extension System
• Alabama Extension, Auburn Outreach Partner With OnMed to Bring Health Care Solutions to Chambers County, Alabama Cooperative Extension System

Challenges

One challenge in launching this initiative has been to build a strong local network to ensure that community members are at the heart of all decisions and implementation steps. One solution that emerged was to build a coalition of community Health Ambassadors who share information and promote healthy lifestyles. This group of ambassadors is comprised primarily of youth and retirees who are committed to their own health as well as supporting the health of their friends, family, and neighbors.

Replication

The Initiative team has focused on building a model that can be replicated across the state, realizing that every community is unique. They have adhered to a 4-step process to implement their patient-centered model.

Additionally, the Initiative team has created a blueprint that includes a task tracker as well as multiple sample documents for reference. The most important step in this process is building relationships within the community, truly understanding local needs and assets, and building a coalition of partners that includes community leaders, community members, local health providers and university faculty and staff.

Contact Information

Hollie C. Cost, Assistant Vice President for University Outreach and Public Service
Auburn University
Auburn University Rural Health Initiative
334.740.2897
hac0043@auburn.edu