Increasing Access to Specialty Care in Rural Missouri with Telehealth


For people living in the rural town of Fordland, Mo., accessing specialty health care from a physician in Kansas City or Columbia means a long drive, time off of work, and lots of gas money. Without ample resources, many choose to go without, sometimes suffering for years with an ongoing health condition.

That’s why Fordland Clinic – a member of Direct Relief’s network and one of only two community health centers in Webster County – decided to implement a telehealth program.

“One of our goals is to remove barriers to care,” said Whitney Keith, community outreach coordinator at Fordland Clinic. “Those barriers aren’t always financial.”

Telehealth – also referred to as telemedicine – is a way for doctors to treat patients via electronic communication using two-way video, email, smart phones, wireless tools and other forms of telecommunications technology. It’s been called “Skype for the medical community.”

Fordland Clinic began offering the service in 2008. Though Fordland only has a population of 800, Fordland Clinic sees 5,000 patients annually from the surrounding areas.

The clinic offers a wide range of services, including urgent care, family care, dental care, and mental health care, but specialized services like dermatology and treatment for children and adults with special needs, like autism, are referred elsewhere – which is where telehealth can help bridge the gap and connect them to reputable specialists.

“They can be sitting in a little clinic in Fordland and have some of these problems solved that they’ve had for years,” she said, adding that she’s seen patients with painful skin diseases like psoriasis finally receive treatment after going without for a long time.

Fordland Clinic is just one of 202 sites in Missouri that are part of the Missouri Telehealth Network, one of the nation’s first public-private partnerships in telehealth.

For other clinics and health centers considering offering telehealth services, Keith said that it has been a very easy process for Fordland Clinic. However, she added that their are two key things to consider: whether the facility has an extra room to dedicate to telehealth that cannot be used by a provider during a session and also if the site can afford to outfit the room themselves.

Keith said the initial costs for the equipment were about $12,000 and the monthly costs for fees and connectivity run at about $900 a month. When a patient comes for a telehealth visit, a nurse sets up the equipment, helps connect the patient to the clinician, and then only stays in the room if necessary.

Keith said Fordland Clinic staff were excited earlier this summer when Missouri governor Jay Nixon signed a state senate bill into law mandating that private insurers cover telemedicine visits and prohibiting them from charging higher rates or high co-pays than in-person visits. This will further decrease barriers to care for people utilizing the services at the clinic.

Giving is Good Medicine

You don't have to donate. That's why it's so extraordinary if you do.