Marcia M. Ward, PhD
Director, Rural Telehealth Research Center
Phone: 319.384.3815
Fax: 319.384.4371
Email: marcia-m-ward@uiowa.edu
Department of Health Management and Policy
University of Iowa
105 River Street, N200 CPHB
Iowa City, IA 52246
- Completed Projects - (16)
- Publications - (21)
Completed Projects - (16)
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Analyzing Data from the Evidence-Based Telehealth Network Grant Program Grantees and Preparing Manuscripts to Further the Evidence Base for Tele-ED
This project's main purpose was to analyze data using the revised Tele-Emergency Performance Assessment Reporting Tool gathered from Evidence-Based Tele-Emergency Network Grant Program grantees on all of their cases using telehealth in the emergency department (tele-ED) and a matched sample of non-tele-ED records to conduct comparative effectiveness analysis to help establish the evidence base for tele-ED.
Research center: Rural Telehealth Research Center
Topics: Critical Access Hospitals (CAHs), Emergency medical services (EMS) and trauma, Telehealth
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Collecting and Analyzing Data from the Evidence-Based Telehealth Network Grant Program Grantees Using the Revised Tele-Emergency Performance Assessment Report Tool
The primary purpose of this project was to collect and analyze data using the revised Tele-Emergency Performance Assessment Reporting Tool from the six Evidence-Based Telehealth Network Grant Program grantees on all their tele-emergency department (tele-ED) cases and a matched sample of non-tele-ED cases to conduct comparative effectiveness analysis to help establish the evidence base for tele-ED.
Research center: Rural Telehealth Research Center
Topics: Critical Access Hospitals (CAHs), Telehealth
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Collecting and Analyzing Data on a Uniform Set of Measures from the Evidence-Based Telehealth Network Grant Program Grantees
The primary purpose of this project will be to routinely collect and analyze data on a uniform set of measures reported by the Evidence-Based Telehealth Network Grant Program grantees to help establish the evidence base for tele-ED.
Research center: Rural Telehealth Research Center
Topics: Critical Access Hospitals (CAHs), Telehealth
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Continuing Data Collection on a Common Set of Measures for the School-Based TNGP Grantees
The primary purpose of this project is to continue data collection from School-Based Telehealth Network Grant Program (SB TNGP) grantees to evaluate school-based telehealth using a common set of measures that will help build the evidence base and inform future policy changes and sustainability efforts.
Research center: Rural Telehealth Research Center
Topics: Healthcare access, Telehealth
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Designing a Study for Collection of Uniform Measures by the EB TNGP Grantees
The Federal Office of Rural Health Policy funded six grantees through the Evidence-Based Telehealth Network Grant Program to implement and evaluate tele-emergency services in rural areas.
Research center: Rural Telehealth Research Center
Topic: Hospitals and clinics
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Establishing a Common Set of Measures for Tele-Behavioral Health and Tele-Substance Abuse
The Rural Telehealth Research Center worked cooperatively with the Federal Office of Rural Health Policy to establish data collection protocols and tools on a set of measures that are being used for a cross-grantee evaluation of the Evidence-Based Tele-Behavioral Health Network Program.
Research center: Rural Telehealth Research Center
Topics: Mental and behavioral health, Telehealth
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Establishing Data Collection Protocols on a Common Set of Measures for the School-Based Telehealth Network Grant Program Evaluation
The primary purpose of this project was to work cooperatively with the Federal Office of Rural Health Policy to establish data collection protocols and tools on a set of measures that can be used for a cross-grantee evaluation of the School-Based Telehealth Network Grant Program.
Research center: Rural Telehealth Research Center
Topics: Quality, Telehealth
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Identify Measures for Use with Tele-Behavioral Health
The Rural Telehealth Research Center identified a set of measures that could be used to evaluate tele-behavioral health services.
Research center: Rural Telehealth Research Center
Topics: Mental and behavioral health, Telehealth
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Investigating Differences in School-Based Telehealth Implementation and Services in the School-Based TNGP Grantees
The principal goal of this project is to gather contextual information from School-Based Telehealth Network Grant Program (SB TNGP) grantees regarding project design and implementation, and the practicalities of delivering telehealth services in school settings that will help explain the heterogeneity found in the data across the grantees.
Research center: Rural Telehealth Research Center
Topics: Healthcare access, Telehealth
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Launch of a Study for Collection of Uniform Measures by the EB TNGP Grantees
Study concepts were vetted, protocols were developed, and this project launched a study where the Evidence-Based Tele-Emergency Network Grant Program grantees began to collect data on a uniform set of measures to help establish the evidence base for tele-ED.
Research center: Rural Telehealth Research Center
Topic: Hospitals and clinics
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Launching Data Collection on a Common Set of Measures for the EB THNP and SAT TNGP Grantees
The primary purpose of this project is to launch data collection among Evidence-Based Tele-Behavioral Health Network Program (EB THNP) and Substance Abuse Treatment Telehealth Network Grant Program (SAT TNGP) grantees on a common set of measures.
Research center: Rural Telehealth Research Center
Topics: Mental and behavioral health, Telehealth
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Launching Data Collection on a Common Set of Measures for the School-Based Telehealth Network Grant Program Evaluation
The Rural Telehealth Research Center worked cooperatively with the Federal Office of Rural Health Policy to establish data collection protocols and tools on a set of measures that are being used for a cross-grantee evaluation of the School-Based Telehealth Network Grant Program.
Research center: Rural Telehealth Research Center
Topics: Healthcare access, Telehealth
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Provide Guidance on Measures for the School-Based Telehealth Network Grant Program Evaluation
The primary purpose of this project was to provide guidance on a set of measures that could be used for a cross-grantee evaluation of the School-Based Telehealth Network Grant Program.
Research center: Rural Telehealth Research Center
Topics: Quality, Telehealth
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Quality of Surgical Care services in Critical Access Hospitals (CAHs)
This project builds on prior work examining rural residents' bypass behavior of their local CAH to hospitals outside their community. Using recently identified inpatient surgical procedures that are commonly performed in CAHs, we will examine and compare outcomes (e.g. post-surgical complication rates, adverse events) of these procedures between CAHs and non-CAHs.
Research center: RUPRI Center for Rural Health Policy Analysis
Topics: Critical Access Hospitals (CAHs), Hospitals and clinics
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Use of Telehealth to Deliver Services to Rural People and Implications for Public Policy
This project analyzes national datasets to examine the extent of use of inpatient telehealth services, organizational factors contributing to use, and payment and other policies that limit uptake. This project will identify approaches that could aid spread of this effective delivery approach throughout rural service areas.
Research center: RUPRI Center for Rural Health Policy Analysis
Topics: Health information technology, Networking and collaboration, Telehealth
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What Factors Explain Rural Residents Seeking Care Outside of the Rural Community?
This project will examine factors that explain rural residents seeking care outside of the rural community.
Research center: RUPRI Center for Rural Health Policy Analysis
Topics: Health services, Hospitals and clinics
Publications - (21)
2021
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Implementation of Telehealth Services in Rural Schools: A Qualitative Assessment
Journal Article
Rural Telehealth Research Center
Date: 11/2021
This study explores facilitators and barriers to implementation of telehealth programs in rural schools and identifies strategies for successful implementation to inform future school-based telehealth initiatives. Researchers conducted semi-structured interviews with 50 key personnel involved in the School-Based Telehealth Network Grant Program. -
Using CPT Charges as an Economic Proxy for Telehealth and Non-Telehealth Emergency Department Utilization
Policy Brief
Rural Telehealth Research Center
Date: 11/2021
This brief examines economic data on emergency department visits from unrelated rural hospitals. By using the reported Current Procedural Terminology code and associated charge, we explore the characteristics of the resulting dataset in terms of distribution and association with related variables. -
HRSA's Evidence-Based Tele-Emergency Network Grant Program: Multi-Site Prospective Cohort Analysis Across Six Rural Emergency Department Telemedicine Networks
Journal Article
Rural Telehealth Research Center
Date: 01/2021
The Health Resources and Services Administration funded six grantees to provide telehealth services in rural emergency departments (tele-ED) and gather data for the telehealth evidence base. This paper examines trends across multiple tele-ED networks and heterogeneity in processes and outcomes.
2020
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Averted Transfers in Rural Emergency Departments Using Telemedicine: Rates and Costs Across Six Networks
Journal Article
Rural Telehealth Research Center
Date: 08/2020
In a cohort of 4,324 tele-ED cases across 26 months in 65 hospitals in 6 tele-ED networks, 20% were averted transfers, and 43% of those were then routinely discharged rather than being transferred. Averted transfers saved on average $2,673 in avoidable transport costs per patient, with 63.6% of these cost savings accruing to public insurance. -
Process of Identifying Measures and Data Elements for the HRSA School-Based Telehealth Network Grant Program
Policy Brief
Rural Telehealth Research Center
Date: 06/2020
This brief details work to identify measures and develop data elements appropriate to school-based telehealth, create an Excel-based tool, and systematically collect data from grantees in the Health Resources and Services Administration's School-Based Telehealth Network Grant Program. -
Measure and Data Element Identification for the HRSA Evidence-Based Tele-Behavioral Health Network Program and the HRSA Substance Abuse Treatment Telehealth Network Grant Program
Policy Brief
Rural Telehealth Research Center
Date: 04/2020
This brief details work to identify measures and develop data elements appropriate to tele-behavioral health, create an Excel-based tool, and collect data from grantees in the Health Resources and Services Administration's Evidence-Based Tele-Behavioral Health Network Grant Program and Substance Abuse Treatment Telehealth Network Grant Program. -
Identifying Measures and Data Elements for the HRSA Evidence-Based Tele-Emergency Network Grant Program
Policy Brief
Rural Telehealth Research Center
Date: 03/2020
This brief details multi-project work to identify measures and develop data elements appropriate to emergency department-based telehealth, create an Excel-based tool, and systematically collect data from grantees in the Health Resources and Services Administration Evidence-Based Tele-Emergency Network Grant Program. -
Emergency Department Telemedicine Consults Are Associated With Faster Time-to-ECG and Time-to-Fibrinolysis for Myocardial Infarction Patients
Journal Article
Rural Telehealth Research Center
Date: 02/2020
Acute myocardial infarction (AMI) is a common, deadly emergency requiring rapid diagnosis and treatment. In this rural cohort, emergency department-based telemedicine was associated with improved timeliness of electrocardiogram and fibrinolysis. This study adds to evidence that telemedicine can improve timeliness of AMI care in rural hospitals. -
Provider-to-Provider Telemedicine Improves Adherence to Sepsis Bundle Care in Community Emergency Departments
Journal Article
Rural Telehealth Research Center
Date: 01/2020
Sepsis is a life-threatening emergency, and timely "bundled" care improves survival. In this rural cohort, telemedicine in the emergency department (tele-ED) improved sepsis bundle adherence, including timely fluid resuscitation and antibiotic administration. Tele-ED may be a scalable intervention to improve sepsis emergency care in rural EDs.
2019
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Emergency Department Telemedicine Consults Decrease Time to Interpret Computed Tomography of the Head in a Multi-Network Cohort
Journal Article
Rural Telehealth Research Center
Date: 11/2019
This was a study of emergency telemedicine (tele-ED) for stroke care in four tele-ED networks. Tele-ED was associated with decreased time to diagnostic imaging interpretation and time to thrombolytic medication. The effect of tele-ED varied by network, suggesting network characteristics may influence the realized tele-ED benefit for stroke care. -
Tele-Emergency Behavioral Health in Rural and Underserved Areas
Journal Article
Rural Telehealth Research Center
Date: 11/2019
This paper describes how two distinct tele-emergency department (ED) behavioral health models address challenges in access and placement for patients in rural and underserved areas presenting to EDs. The notable difference in disposition rates between cases and controls shows the impact each model is having on care practices and processes. -
Pediatric Tele-Emergency Care: A Study of Two Delivery Models
Journal Article
Rural Telehealth Research Center
Date: 04/2019
This study describes two tele-emergency programs that provide care to pediatric populations. Qualitative descriptions of the two tele-emergency department (ED) models and key characteristics of the patient populations served by tele-ED are presented. The study informs others about evaluative measures and how tele-ED works in practice.
2017
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Improving Access to High Quality Sepsis Care in a South Dakota Emergency Telemedicine Network
Policy Brief
Rural Telehealth Research Center
Date: 08/2017
This brief describes an implementation initiative designed to increase use of emergency department-based telemedicine consultation for patients with severe sepsis or septic shock. This initiative is the first step of an analysis to estimate the effect of telemedicine on sepsis care and outcomes. -
Telemedicine Use Decreases Rural Emergency Department Length of Stay for Transferred North Dakota Trauma Patients
Journal Article
Rural Telehealth Research Center
Date: 07/2017
This article examines the use of telemedicine to help improve care for trauma patients and to try to close the gap between rural and urban outcomes for these patients. The study involved patients treated in critical access hospitals and emergency departments. -
Emergency Department Telemedicine Is Used for More Severely Injured Rural Trauma Patients, but Does Not Decrease Transfer: A Cohort Study
Journal Article
Rural Telehealth Research Center
Date: 02/2017
Traumatic injury is a leading cause of death in the U.S. Rural residents have limited access to trauma care, and telemedicine has been proposed to improve trauma care locally. This study describes patient-level factors associated with telemedicine and measures the association between telemedicine consultation and interhospital transfer.
2016
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Telemedicine Penetration and Consultation Among Rural Trauma Patients in Critical Access Hospital Emergency Departments in North Dakota
Policy Brief
Rural Telehealth Research Center
Date: 09/2016
This study describes the penetration of ED-based telemedicine in North Dakota critical access hospitals and its use for rural trauma patients. Investigators showed that telemedicine subscription increased to 81 percent of rural North Dakota hospitals, and 11 percent of patients in a telemedicine-capable ED used telemedicine as part of their care. -
Surgical Patient Safety Outcomes in Critical Access Hospitals: How Do They Compare?
Journal Article
RUPRI Center for Rural Health Policy Analysis
Date: 02/2016
Examines how Critical Access Hospitals perform compared to Prospective Payment System hospitals on measures of quality.
2015
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Rural Bypass for Elective Surgeries
Journal Article
RUPRI Center for Rural Health Policy Analysis
Date: 11/2015
Describes the elective surgical bypass rate, the procedures most commonly bypassed by rural residents, the distribution of volume among Critical Access Hospitals (CAHs) that offer elective surgical services, and factors predictive of bypass. -
Hospital Views of Factors Affecting Telemedicine Use
Policy Brief
RUPRI Center for Rural Health Policy Analysis
Date: 04/2015
This brief expands upon previous research by examining hospital-based use of telemedicine by determining the type of use by hospitals, whether it be providing services as a hub or receiving services as a spoke, and then identifying factors from the hospitals' perspectives that affect use. -
Surgical Services in Critical Access Hospitals, 2011
Policy Brief
RUPRI Center for Rural Health Policy Analysis
Date: 02/2015
This brief describes the types and volume of major surgical services provided in critical access hospitals across four regionally representative states in 2011.
2014
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Extent of Telehealth Use in Rural and Urban Hospitals
Policy Brief
RUPRI Center for Rural Health Policy Analysis
Date: 04/2014
This brief provides discussion with statistics on the use of telehealth in rural hospitals and the opportunities telehealth can bring to supporting healthcare in rural communities.