‘Take it to the people’: Inside the Rise of Virtual Care in Rural South Carolina
Caitlin Moore’s mornings while studying abroad in Costa Rica began with an hourlong bus ride followed by an hourlong walk, traveling with local healthcare professionals into beautiful but remote pockets of the country. There, she assisted with pregnancy screenings and supported hypertension and diabetes management for people who could not make it to neighborhood clinics.
When the program ended, Moore returned to South Carolina and joined Clemson Rural Health, determined to support underserved communities at home. To her surprise, she encountered the same needs and barriers she saw in Central America: people with high-risk pregnancies and chronic conditions who struggled to access necessary care.
“What I was seeing in Costa Rica in 2010, we’re still seeing in South Carolina in 2023,” the nurse practitioner said. “That’s just shocking.”
But something has changed in the years since Moore went from being a wellness coordinator to the organization’s associate director of clinical operations: technology.
Moore and her colleagues now deliver essential healthcare support directly to rural areas of South Carolina with remote monitoring devices and a virtual care platform. Digital bridges span the divide between patients and providers, connecting doctors’ offices with living rooms across the state. And that has made Clemson Rural Health’s clinicians all the more capable of making a difference.
Delivering Virtual Care in the Real World
With five locations and nine mobile health units that travel to 78 sites, Clemson Rural Health offers comprehensive support to people across South Carolina. The organization provides evidence-based care integrated with nutrition, social work, and education.
Clemson Rural Health’s teams have traveled some 55,000 miles to deliver care on their mission to reduce premature mortality and preventable hospitalizations. But the organization didn’t stop there.
Clemson Rural Health partnered with Carium through Palmetto Care Connections, a telehealth network that assists health care providers in connecting rural and underserved South Carolinians to quality services through broadband, technology and telehealth programs.
With Carium, they are able to deploy an end-to-end virtual care platform to further reduce barriers posed by social determinants of health by meeting patients where they are.
“Our partners knew that we were the ones who would really adopt technology and embrace it and figure out how to take it to the people,” Moore said.
That’s precisely what Clemson Rural Health did.
Today, the platform augments the organization’s brick-and-mortar hubs and traveling clinics, empowering patients and providers to work together to improve health outcomes.
Supporting Patients and Providers
Too often, digital solutions frustrate and disrupt the already complex task of healthcare delivery. Multiple channels, glitchy interactions, and puzzling user interfaces build barriers between patients and providers instead of uniting them.
Clemson Rural Health sought a different kind of virtual care platform, and Palmetto Care Connections was poised with the right digital health solution to meet their needs.
It enables patients to easily communicate with providers about everything from quick check-ins to ongoing management of chronic conditions — even when mobile units are not in the area. South Carolinians can also connect the platform to remote patient monitoring devices and record critical data about their healthcare journeys. That means they can focus on their health instead of worrying about booking appointments, organizing time off work and childcare, and traveling to clinics.
“By implementing remote patient monitoring, we’re mitigating that determinant, but we’re also giving them control over their health,” Clemson Rural Health’s director of communications, Dianna Colvin, said.
And providers take to the app, too. Clemson Rural Health’s multidisciplinary care teams use the platform to closely monitor patients and adjust treatment plans from afar. Their support goes beyond standard care. For example, community health workers can use the app to message patients who screen high for food insecurity, connecting them with locations of local food banks and offices to register for the Supplemental Nutrition Assistance Program.
Taking Care of High-Risk Communities
One of the most impactful applications of the virtual health platform is support for patients with chronic conditions.
Thanks to a grant funded by BlueCross BlueShield of South Carolina Foundation in support of the goals of Diabetes Free SC, Clemson Rural Health launched an intervention program for women with prediabetes and diabetes.
After going live in January 2023, the program has already helped 39 women manage their condition through close contact with care teams and the support of smart devices like continuous glucose monitors, weight scales, and pulse oximeters. Regular access to timely and accurate data helps providers make evidence-based decisions. And they further support patients with classes led by diabetes educators.
Clinicians who work on an initiative to help women manage their diabetes and hypertension during pregnancy applaud the Carium app for putting patients at the center. Both conditions need early and continuous attention, as they can threaten the health of mother and child.
Whether in her office or on the road with the mobile health unit, clinicians can use the app to check patients’ biometric data, answer their questions, and adjust their medication. Video calls let support consultations with patients and their families, no matter where they live. The best part? Expectant mothers don’t need to carve out time to travel to the clinic.
One mother with Type 1 diabetes called a Clemson Rural Health nurse practitioner the moment she thought she was pregnant with her third child. The clinician immediately set up the woman on the Carium app. Three months later, the mother had drastically reduced her blood sugar and was heading for a healthy range. She is one of the 53 women the initiative has supported this year.
Care doesn’t stop at delivery. “No matter where you enter services with us, we’re not just taking care of you for one stage of life,” Moore said. “We can take care of you across the lifespan.”
Expanding Services While Staying Put
The combination of reliable data and a patient-centered approach to care is already transforming health outcomes. “We’re seeing improvements in everybody who’s enrolled, whether it’s blood pressure, or weight, or blood glucose,” Moore said.
“We’re seeing improvements in everybody who’s enrolled, whether it’s blood pressure, or weight, or blood glucose.”
Given these successes, Clemson Rural Health is looking to incorporate remote patient monitoring into an upcoming initiative for chronic kidney disease. The goal is to intervene early and help patients slow the progression of the disease with medication and lifestyle modifications.
As new programs take off and existing initiatives mature, the team is collecting evidence of virtual care’s value. Many people have been reticent to endorse remote patient monitoring, saying supporting literature comes from studies conducted outside the state, Moore explained. Her goal is to prove to them what she knows without a doubt: Virtual care works in South Carolina.
Whether the naysayers change their minds or not, one thing is certain: Clemson Rural Health and its virtual care platform aren’t going anywhere.
“We want to be a part of the community. We want to go in, give them the tools to change their health,” Colvin said. “We’re going to be here forever.”
Rural areas have long confronted steep barriers to care. Hospitals, urgent clinics, and specialists aren’t around the corner like they are in cities. The challenge of securing transportation, time off work, and childcare makes medical appointments a luxury for too many people. Read more about how Clemson Rural Health is solving for these challenges.
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