Efficiently Meeting the Need for Cataract Services in a Rural Area

Leah Gunther, Surgical Services Manager, West River Health Services

The healthcare community has heard over and over about the effect the aging population will have in the coming years. While any healthcare facility must consider the demands of an older population in developing its services, at our facility in rural North Dakota this is even more vital. Almost 20 percent of our state population is 60 years old or older—slightly higher than the national rate of 18 percent. By 2030, the national proportion of people over 60 years old is expected to grow to almost 25 percent. Projections like this tell us that it is more important than ever that our health system is prepared to treat senior-aged patients and respond appropriately to the conditions that affect them the most.

Our facility, West River Health Services, is located in southwest North Dakota, with a main branch in Hettinger—population 1,300—as well as seven satellite facilities in the surrounding area. Our system covers a service area of over 25,000 square miles, and provides services for more than 25,000 people. In our 25-bed main facility, we offer obstetric and ICU services, as well as surgery services in a new suite that was constructed two years ago. With these locations, we are proud to reach out to the small towns around us and provide services to rural people who would otherwise have to make a lengthy drive for healthcare. As we continue to refine our programs and offerings, the National Rural Health Association has become an invaluable resource for ideas.

Vision Care in a Rural Setting

Ophthalmology is one treatment area in which we believe it is especially important to provide care for patients close to home, as patients with compromised vision very often should not and cannot drive. For many senior-aged patients, the task of finding a reliable friend, family member or caregiver to help transport them is daunting, and many patients dislike imposing on their families for transport over long distances for medical care. For patients in Hettinger, Bismarck, the nearest sizable community with sophisticated healthcare services, is nearly three hours away. Thus, providing reliable and high quality ophthalmology care is important to us in our mission to help these patients stay close to home.

As with many other age-related conditions, the prevalence of ophthalmic problems such as cataracts is expected to increase significantly over the coming years. Currently, approximately 20.5 million Americans older than 40 are affected by the condition, and this is projected to increase to 30.1 million by 2020. Providing cataract services is therefore a priority for our health system.

For a rural system like ours, however, the logistics of providing cataract services can be prohibitive. Purchasing and maintaining surgery equipment and tools is simply not feasible with our limited budget. Fortunately, we have a system in place that allows us to offer our patients state-of-the-art cataract care close to home, without capital investment or maintenance concerns for West River Health Services.

An Outsourcing Solution

By utilizing Sightpath Medical’s mobile services, we are able to offer cataract surgery to patients on the second Tuesday of every month at our Hettinger facility. By contracting with this mobile service, the equipment, instruments, surgical supplies and Intraocular lenses (IOLs) necessary for the procedure are delivered to our facility by a National Board of Surgical Technology and Surgical Assisting (NBSTSA) certified surgical technician. We have built a relationship with an ophthalmologist from Bismarck, who flies in and typically performs 13 surgeries in a day. The following day, the ophthalmologist sees post-op patients in our clinic and also consults with the next month’s surgical candidates. The service is paid for on a per-case basis, and the demand is such that our facility actually caps the number of surgeries each month in order to maintain an optimum caseload for our ophthalmologist. With this arrangement, we are able to maximize the doctor’s time in our facility while still providing the highest quality care.

A key benefit of using Sightpath is that our facility is able to utilize the company’s surgical technicians. After setting up the equipment on surgery day, the Sightpath technician stays on site to assist in procedures and ensure the equipment runs smoothly. These professionals are NBSTSA certified, specialize in ophthalmology, and are highly experienced, due to the fact that they work in many different facilities. Because of this, they are also accustomed to the varying procedures and protocols of each facility, and are very conscientious about following our specific policies.

With this arrangement, our facility is able to offer top-of-the-line cataract service with state-of-the-art equipment to patients with no capital investment. We have eliminated the need to allocate staff time to manage inventory and maintain equipment for our once-a-month surgery days. Additionally, our surgeon can upgrade to new equipment as the technology evolves, and he also has his choice of instruments, supplies and IOLs. Our surgeon has been truly impressed with our facility’s turnover time and ability to run efficiently, and our relationship with Sightpath Medical helps ensure that his time here runs smoothly, which enhances our relationship with him.

Pride in our Capability

We are proud to have the ability to offer cataract surgery to our patients, and this service is greatly appreciated by both patients and their families. In our rural area, as in many others, cataract surgery is a much-needed service, and the need can only be expected to increase as time goes on. By teaming with Sightpath Medical, we are able to meet the demand for this service in a way that is beneficial for patients, our surgeon and our facility.