Transfer Centers Spell Relief for Rural Docs

The transfer center process reduces extraneous calls and time for ED physicians for care, says Rick Newman, director of the Mountain States Health Alliance's medical transfer center. The MSHA includes hospitals, 21 primary and preventive care centers, and numerous outpatient sites operating in 29 counties in Tennessee, Virginia, Kentucky, and North Carolina.

After the health system began a call-center and tentatively started its transfer center in the 1990s, the health system transferred about 850 patients a year. Now it transfers about 1,100 a month, with 10% of admissions impacted by the call center. ED physicians "were begging us to assist them," says Newman, a longtime engineer. "The ED physicians have an easy way to set up the transfers to move patients in and out the door to a higher level of care," he says.

"If anybody presents at the ED in any of these disease states, or in critical condition, the ED physician is going to have to transfer them to another facility," Newman says.  "At the ED, there may be a roomful of patients, and some hospitals may not be able to admit them because of their condition, and need to move them out quickly."

Newman says the transfer centers are particularly important in rural areas. In some cases, patients may have "gone to their local ED and they've been seen by a physician and essentially a determination is made they cannot meet the patients' needs," Newman says.

"In Northeast Tennessee, it's very rural, so hospitals in the network may not have orthopedic services available, or they may have no neurological surgeons," he explains. About 60% of transfers are from the ED, he says.