Dartmouth-Hitchcock, West Health Partner on Geriatric Emergency Department

Oct. 29, 2019
Collaboration will evaluate the effectiveness of using telemedicine to extend the reach of GED to rural hospitals

Dartmouth-Hitchcock Health (D-HH) is partnering with West Health in a $4.5 million research collaboration to create what they call the first "Geriatric Emergency Department" (GED) to focus on a largely rural population.

Lebanon, N.H.-based D-HH serves a population of 1.9 million across Northern New England. West Health is a family of nonprofit and nonpartisan organizations, funded by philanthropists Gary and Mary West, dedicated to lowering healthcare costs to enable seniors to successfully age in place.

The organizations note that the largely rural setting of Northern New England offers unique obstacles to implementing improved acute care for the growing population of senior adults. The region is one of the United States' most rapidly aging regions, with Vermont and New Hampshire being the second- and third-oldest states, respectively, by median age. Older adults who live in poverty are significantly more likely to live in rural areas. Limited access to health services, workforce shortages, social isolation, and transportation problems are particularly severe in these remote regions. Caring for older adults in rural areas such as Northern New England requires innovation in geriatric emergency medicine.

The collaboration will evaluate the effectiveness and sustainability of using telemedicine to extend the reach of a GED to rural hospitals, and create opportunities to scale the concept to other rural facilities across Northern New England and throughout the country.

The GED is designed with protocols, resources, and specialized care areas to optimize the acute care of older adults.  Over the course of the three-year research collaboration, the West Health Institute will contribute expertise and $3 million in capital to establish Dartmouth-Hitchcock Medical Center in Lebanon (DHMC) as a center for geriatric emergency care. The collaboration will develop and implement protocols, resources, and specialized care areas within the Emergency Department at DHMC, all to optimize the acute care of older adults.

After DHMC earns accreditation from the American College of Emergency Physicians (ACEP) as a top-tier, Level 1 GED, its specialized services will be offered with DHMC as the "hub" to four "spoke" sites around the region through D-HH's Center for Telehealth. D-HH has committed an additional $1.5 million to the overall project cost.

"Seniors who seek treatment in EDs are often highly complex patients with various medical and social issues that are challenging for any ED, and can be especially challenging for rural hospitals with fewer resources," said Scott Rodi, M.D., interim section chief and regional director of emergency medicine at DHMC, in a statement. "This partnership with West Health will enable us to work with our rural colleagues to provide specialized, senior-specific care to more patients throughout the region. It's another step forward in our vision to improve access to high-quality health care for all people, regardless of where they live."

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