2012 Annual Evaluation Report: St. Joseph Health System/Kentucky Health One

Through its Virtual Primary Care Delivery initiative, the St. Joseph Health System's (SJHS) goal is to increase access to primary and specialty care services by establishing two fixed-site primary care clinics, in Clay City/Powell County and Campton/Wolfe County, Kentucky. The clinics would be managed by Advanced Practice Registered Nurses (APRN) and virtually linked to physician specialists in Lexington and Mt. Sterling via telehealth technologies.

The purpose of this evaluation was to provide program staff and funders information about the implementation of these two rural clinics and provide preliminary evidence of program impact by documenting program outputs and outcomes.

The study found that:

• In 2012, there were 687 unduplicated patients seen in all clinic locations. Implementation of telemedicine services was delayed through the end of 2012. Only a few telemedicine consults were held to test the system and equipment. The absence of telemedicine services significantly lowered the anticipated return patient visits that would have likely been for telemedicine consultations with specialty providers.

• The average patient at these clinics identified as white, was between 40 and 64 years of age, had an income of less than $10,000 per year, and had a high school diploma as their highest educational attainment. Patients were mixed in terms of working full-time, part-time and not at all. Most patients had either public insurance (Medicaid, Medicare) or were paying out of pocket.

• All clinics combined, the average change in miles travelled for care per unique patient fell from 5.1 to 2.8 and per visit from 16.0 to 10.5.

• Some evidence suggests improved health care utilization and satisfaction with care.