Telehealth Pioneer Brings Tech Changes to Rural Hospitals and Patients

Dr. Kristi Henderson, Ph.D., has always loved change – and the unexpected.

We recently met when our Dell Services team came together with Dr. Henderson and her team to collaborate on ways to use telehealth to connect patients with providers to offer on-demand care, and I can already tell I have much to learn from this agent of change.

She’s Seton Healthcare Family’s new Vice President of Virtual Care and Innovation, a nurse practitioner with a passion for finding new ways to solve longstanding problems.

It’s passion that led her to initiate the first ER telehealth pilot in the rural south.

Early in her career as a clinician, on rounds in the academic medical center in Jackson, Mississippi, Henderson saw patients queued up in the corridors because demand outweighed capacity. Hospital rooms were at a premium. Meanwhile, across the Delta, rural hospitals, in the communities where these patients lived, sat empty —  or worse – were threatening to close.

“It was a total misalignment, with our community hospitals struggling to stay open and the emergency departments of city hospitals overstretched,”  Henderson said.

Like many rural hospitals, these facilities could not attract enough specialized clinical staff to serve local needs.

“I asked ‘Why can’t we just use who’s out there? Why can’t we connect them to the expertise and then co-manage patients together?”

Her team found an answer to the problem in telehealth technology.

Connecting the Delta — From the Catfish Capital to Jackson

In 2003, Dr. Henderson and her team began connecting rural hospitals with the medical center, starting with three little communities. The first was Belzoni in Humphreys County Seat, population 2,663, on the banks of the Yazoo River. (“The ‘catfish capital of the world’ – a very, very rural, underserved and high poverty area,” she said.)

Dr. Henderson’s team connected Belzoni’s only hospital to the academic medical center in Jackson. Then they added Port Gibson, population 1,567, deep in the Delta southwest of Jackson, very poor and underserved, and the neighboring Holmes County Seat of Lexington, Miss., population 2,025.  

The team worked with what they had – a point-to-point T1 fiber optic line that stretched the entire 64 miles between the two hospitals in Belzoni and Jackson, and the 116 miles between Port Gibson and Lexington.

“It took 90 days to get it installed – to get the fiber in the ground,” she said. “If a farmer hit the line with his backhoe, the whole system went down (and he did, and it did).  So we learned a lot.”

But Dr. Henderson and her team made it work. They were connecting the specialists in the larger medical centers to the patients in their rural hometown hospitals at their critical points of care in a pioneering smart network.

They developed a 24-hour program with ER physicians collaborating with the rural hospitals and their patients.  They used video conferencing and telehealth carts (with biometric monitoring devices) to connect the caregivers and patients to staff at the medical center in Jackson.

“It took us three years to get it approved through the medical and nursing board,” Dr. Henderson recalls. No one else was using telehealth in a program like this. “No one was really sure if this would work.”

Keeping patients near home and keeping their home hospitals thriving

It did work. Admissions to the rural hospitals increased 20%, reducing unnecessary medical transfers and taking some of the pressure off the Jackson ER. The community hospitals that were facing closure now had a revenue stream from patients who stayed in the community and were virtually connected. The Jackson team pushed their consults up from 200 to 8,000 per month – everything from ER to pediatric care to chronic adult care – with teams using telehealth everywhere to connect to remote clinical access points. 

“The biggest impact was we were able to give care to people sooner,” Dr. Henderson said.

“So instead of them driving to Jackson with some of these conditions that were life threatening, we were saving peoples’ lives (by treating them locally). Everybody won,” she said.

And, their program began to grow. It was the catalyst for every other program in their area, expanding to 35 specialties in 213 sites around the state of Mississippi.

Dr. Henderson would go on to guide others nationally on implementing telehealth — testifying before the U.S. Senate and Congress. While that success has been gratifying, it’s the stories of patients that mean the most, she said.

“Every day I heard stories that blew me away,” she said.

In particular, she remembers a boy who was accidentally shot in the chest when his gun backfired. “He was saying ‘goodbye’ to his family as they were frantically driving him to the convenience store where an ambulance would then meet them.” Luckily, the ambulance was close to a hospital in the telehealth program. Though it didn’t have an ER specialist or trauma team, the staff connected with ER trauma specialists who talked them through the boy’s care. They resuscitated him and flew him to the closest hospital for immediate surgery.

“Now he’s fully functioning, he’s finished high school and has only a scar to show for the traumatic event,” she says. Without the telehealth program, “they would have done the best they could they would not have been able to save the boy’s life.”

In her new role at Seton, Dr. Henderson is excited about expanding the use of technology to improve care. “Within Ascension (the parent organization for Seton Healthcare Family), they have senior care; they have home health – those are all areas where we could make a difference using technology. And, they have more than 2,000 sites of care, including 137 hospitals and more than 30 senior care facilities, across 24 states and Washington, D.C.  So it’s a platform where I can take the work that was done in Mississippi and scale it to a much larger level.

“Every day I cannot believe I’m doing this and how well it works,” Henderson said. “And that’s why I came here because everyone needs to have access to this kind of service in healthcare – because it works.”

Listen to Dr. Henderson’s podcast with Dr. Jay Sanders, founder and past president of the American Telemedicine Association, on how telecommunications technology is revolutionizing the delivery of healthcare in the U.S.

About the Author: Gigi Shamsy Raye