Newsroom | Community Health

Sickness rarely waits for a good time to strike — something Michelle Morgan knows all too well.

“My children never got an ear infection on a Tuesday morning,” says Morgan, the economic coordinator for Milam County, Texas. “It was always a Friday night or Sunday.”

This is a familiar and stressful dilemma for people in Milam County. Both hospitals in the county closed recently, leaving people with the choice of waiting until Monday to see a primary care doctor or driving 45 minutes to the nearest urgent care clinic.

“After 5 p.m., there’s nothing open 40 miles in any direction,” says Dr. Joy Alonzo, principal investigator with Texas A&M University in College Station. “That describes 75% of Texas or more.”

People living in rural areas of the U.S. are more likely to die from heart disease, cancer, unintentional injuries and strokes than people living in urban areas — due in part to trouble accessing care.

And more traditional solutions to care access, like in-home telemedicine, aren’t realistic for rural areas of the country because of lack of access to secure broadband connections. According to the Federal Communications Commission, more than 21 million Americans don’t have access to broadband. 

A Texas A&M project, funded by Health Care Service Corporation's Texas plan, is testing innovative ways to solve the problem of rural access to care.

“We provide coverage in all 254 counties throughout Texas,” says Shara McClure, divisional vice president of health care delivery for HCSC's Texas plan. “It’s part of our mission to make sure we have affordable accessible health care.”

In Milam County, that means a new telemedicine “kiosk” or health care station for residents in need of urgent care outside of normal office hours. The health care station is in the lobby of the county sheriff’s office, which has reliable internet access and is open 24-7.

No appointment is needed. Anyone can walk up, pay $65 and see a provider in the Texas A&M Health-sponsored OnMed station. The providers are Texas-licensed but located in Florida, where OnMed is based.

The standalone booth has glass doors that fog up and lock for privacy once a patient is inside. From there, the patient pushes a button to start the visit. An OnMed clinician appears on a large screen to take the patient’s vitals from hundreds of miles away, with the assistance of a scale on the floor, a thermal scanner to take temperatures, a pulse oximeter, a blood pressure cuff and stethoscope.

A nurse practitioner then comes on screen to talk with the patient and make a diagnosis. If medication is needed, the booth has that covered, too. A pharmacy robot located in the secure vault can dispense commonly prescribed medications.

“Even though it’s a virtual visit, it really gives you the feeling that you’re right in front of someone,” Morgan says of the overall experience. “You don’t need to know technology. You literally just walk in and press start.”

Once the visit is over, UV light sanitizes everything in the booth, and it’s ready to go for the next patient.

Expanding the impact

The kiosk is proving to be popular in Milam County — 10 patients used it in its first three weeks after it opened to the public Oct. 1.

Alonzo and the project team at Texas A&M will track the health care station’s success and fund it through 2022. If data shows improvement in access and affordability, similar solutions could be deployed elsewhere. The Texas A&M team is planning to install another five telemedicine kiosks across the state, if funding can be secured.

“Living in a rural county is considered a health risk,” Alonzo says. “We want to change that dynamic and have equal access to health care for everyone.”