Rural Health Technology "Not Going Away"

Rural Health Technology "Not Going Away"

James Partin, M.D., Internal Medicine, Chief Medical Officer, Hill Country Memorial Hospital

One outcome of dealing with COVID-19 is the increased role technology will play in delivering health care to rural community hospitals. Such is the case at Hill Country Memorial, based in Fredericksburg, Texas.

Hill Country Memorial is a multi-faceted healthcare system that expands to 10 locations in four counties, and services include Home Care, Hospice, Wellness Center, and 40+ specialties. One of the locations is an 84-bed facility that has served eight counties in Central Texas for 50 years. While non-profit and non-tax-supported, HCM is nationally recognized, including winning the Malcolm Baldrige National Quality Award in 2014 and being named a 100 Top Hospital in 2019.

In an area where major medical centers are more than one hour away, the hospital’s embrace of technology to serve its patient base has become more vital than ever, according to James Partin, M.D., Internal Medicine, Chief Medical Officer.

“I’ve said this from very beginning of the COVID pandemic,” Dr. Partin said. “What we are learning now is that we can actually care for a patient through technology and telemedicine interfaces. That’s not going away.”

Dr. Partin describes some of the technologies HCM already makes available to its patients:

3 Tesla MRI

“We raised enough funding to buy a new 3 Tesla MRI to replace our 1.5 Tesla. This has allowed us to see images we would otherwise be unable to obtain.”

DaVinci Surgical System

“Our surgeons have embraced this technology for its amazing views and preciseness of manipulating the instruments inside the body, and patients are beginning to ask for it.The DaVinci Surgical System has allowed us to do surgical procedures we otherwise likely would have to transfer patients for–hernia repair, prostate procedures, and gynecological issues.”

3-D Mammography

“This has allowed the radiologists to have a much clearer view of the breast, and much less need for biopsies or repeat mammograms. It has significantly supplemented the radiologist’s ability to detect and rule out tumors of the breast.”

IBM’s Watson Assistant for Citizens

“Watsonsartificial intelligence platform allows interactive conversations with patients. It doesn’t need to be preprogrammed. Watson can interpret what the user is asking about. This technology has really helped us respond to COVID questions from the public.”

Thermal Scanner

“It monitors the person’s temperature and also reads the badge so it can make a record of the temperature at the time. Placing these at our hospital entrances has freed up personnel and made monitoring visitors non-contact.”

One of the biggest game-changers is telemedicine, which allows local access to medical specialists who otherwise would not be available.

“Telemedicine is one technology that has been a major investment of ours,” Dr. Partin said. “It has allowed us to bring in specialists we can’t actually recruit because we don’t have the volume.”

One example of this technology’s impact is the case of Fredericksburg resident Kaleb Brewer, a father of seven who came to the hospital in critical condition with pneumonia. Brewer says telemedicine “saved my life.”

“My wife brought me to Hill Country Memorial because this is our hometown,” Brewer said. “Plus, it was the closest place. If they had sent me to another hospital, I would have gone through a lot of troubleshooting steps and probably not have made it.Because of telemedicine–what I call ‘doc in the box’–it allowed for faster treatment of what was going on.I could be here at my hometown hospital, but through telemedicine, get the specialized care I needed.”


While high speed internet is not in all homes in remote parts of Texas, nearly everyone has access to some type of smart phone. That is enough to serve as a portal for “virtual visits” with their family practitioners.

This brings up the question of how technology will change the “practice” of medicine. What will be the new role of the family doctor in this brave new world?

According to Dr. Partin, technology is never a replacement for the personal bond between physician and patient, which is one of the hallmarks of a community hospital.

“When I took a patient’s medical history, I had already formulated a possible diagnosis,” he explained. “The office visit was to confirm if my thought process was correct. There is always going to be a need for a physical exam.”

But increased reliance on technology to do even that is a certainty.

“It’s the wave of the future; we are pushing toward those technologies. Telemedicine can allow us to use someone remotely to help with the examination. The neurologist can have assistance by a nurse to do full neurological and stroke scale evaluation even when the neurologist is 500 miles away.”

More significantly, technology is showing how many more ways a medical staff can bring care to patients outside the hospital.

“We are moving to getting care to patients where they want it and how they want it,” Dr. Partin said. “We are able to remote monitor blood pressure, weight, blood sugar, heart rhythms, and other data using wearables. Patients now come to expect not have to drive 45 minutes and sit in a waiting room up to an hour to be seen. That can be done remotely in a home or business. That is not going away.”

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