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


Current Projects - (1)

Provide Guidance on Measures for the School-Based Telehealth Network Grant Program Evaluation
RTRC will work cooperatively with FORHP to provide guidance on a set of measures that could be used for a cross-grantee evaluation of the SB TNGP. A secondary goal is to identify lessons learned from this effort that could be useful in designing future TNGP cooperative agreements.
Research center: Rural Telehealth Research Center
Topics: Quality, Telehealth

Completed Projects - (6)

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 EB TNGP grantees to help establish the evidence base for tele-ED.
Research center: Rural Telehealth Research Center
Topics: Critical Access Hospitals and Rural Hospital Flexibility Program, Telehealth
Designing a Study for Collection of Uniform Measures by the EB TNGP Grantees
The purpose of this project is to design study concepts whereby the EB TNGP grantees will be able to collect data on a uniform set of measures to help establish the evidence base for tele-emergency.
Research center: Rural Telehealth Research Center
Topic: Hospitals and clinics
Launch of a Study for Collection of Uniform Measures by the EB TNGP Grantees
Once study concepts are vetted, protocols will be developed and this project will launch a study where the EB TNGP grantees begin 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
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 and Rural Hospital Flexibility Program, Hospitals and clinics
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, Health policy, Networking and collaboration, Technology, Telehealth
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 - (8)

  • Emergency Department Telemedicine Is Used for More Severely Injured Rural Trauma Patients, but Does Not Decrease Transfer: A Cohort Study
    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.
  • Extent of Telehealth Use in Rural and Urban Hospitals
    Policy Brief
    RUPRI Center for Rural Health Policy Analysis
    Date: 04/2014

    Provides discussion with statistics on the use of telehealth in rural hospitals and the opportunities telehealth can bring to supporting healthcare in rural communities.

  • Hospital Views of Factors Affecting Telemedicine Use
    Policy Brief
    RUPRI Center for Rural Health Policy Analysis
    Date: 04/2015

    This Policy Brief expands previous research examining hospital-based use of telemedicine by 1) determining the type of use by hospitals, whether it be providing services as a hub or receiving services as a spoke; and 2) then identifying factors from the hospitals’ perspective that affect use. Key informants at 36 hospitals were interviewed. The hospitals were evenly split between urban/rural and hub/spoke in 22 states, representing all four U.S. Census Regions. Respondents reported factors that initiated telemedicine use at their hospitals, such as a variety of start-up funding from federal, state, and foundation sources. They reported benefits, such as meeting hospital missions and improving patient access, as well as challenges, such as reimbursement procedures and clinician buy-in. They also discussed barriers to expansion, such as licensing and credentialing policies. While challenges and barriers are significant, both hub and spoke hospital respondents state considerable benefits for continued telemedicine use.

  • 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.
  • Rural Bypass for Elective Surgeries
    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 CAHs that offer elective surgical services, and factors predictive of bypass.
  • Surgical Patient Safety Outcomes in Critical Access Hospitals: How Do They Compare?
    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.
  • 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 (CAHs) across four regionally representatives states in 2011. Of the surgery volume performed in CAHs, on average 77% was performed on an outpatient basis and 23% inpatient. Operations on the musculoskeletal system, the eye, and the digestive system accounted for 67% of all surgical procedures performed in CAHs. Most reports of surgery volume in CAHs focus on inpatient procedures, thus missing a significant portion of the surgery volume that CAHs perform. CAHs offering outpatient procedures that complement inpatient surgical capacity are providing the communities they serve significant and valuable services through access to both convenient and emergent surgical care services that lessen many of the healthcare burdens associated with travel for surgery and follow-up care.

  • 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.