(Pueblo Chieftain, The (CO) Via Acquire Media NewsEdge) Dec. 30--One of the realities of life in rural Southern Colorado is limited access to specialty medical care.

Pueblo's two regional medical centers -- St. Mary-Corwin and Parkview -- fill the gaps by providing inpatient and outpatient care to out-of-town rural dwellers, as well as on-site clinics in their hometowns and training for rural providers.

Both hospitals work closely with hospitals in eight outlying counties and serve patients from 14 counties outside of Pueblo, bringing their estimated total service-area population to 350,000.

Patients from surrounding counties make up roughly one-quarter of annual admissions, including those for diagnostic testing and other outpatient procedures, at both local hospitals.

At Parkview, according to Community Outreach Coordinator Alexis Rodman, the bulk of nonresident inpatient services are in the areas of obstetrics, medical/surgical care and cardiac care. Since the current fiscal year that began in July, for example, 22 percent (3,529) of the hospital's 16,161 inpatient admissions involved out-of-town patients, Rodman said.

Of the non-local patients, 547 were admitted for obstetrics and 504 were admitted for reasons other than surgery. The majority of the remainder were surgical or cardiac patients, Rodman said.

Among outpatients treated at Parkview since July, 12,594 of the 113,642 total were from outside Pueblo County. Those figures include 4,379 emergency room visits, 2,590 for radiology or diagnostic imaging services and 2,025 for same-day surgery.

Since March, Southern Colorado Emergency Medical Associates (the physicians that

staff the emergency departments at Parkview's Downtown emergency room and Pueblo

West emergency clinic) have provided staffing for the emergency department at

Mount San Rafael Hospital in Trinidad.

"This partnership has helped the residents of Trinidad receive emergency medical services 24 hours a day, seven days a week. This gives our physicians the opportunity to view rural health care at the front lines," Rodman said.

Providing higher levels of care in rural communities is part of an effort on Parkview's part "to make sure that we are partners to the health-care providers in our rural areas, not competitors," she added.

Parkview regularly provides on-site education and training classes to clinics, hospitals and physicians' offices to keep health-care providers in rural communities and help them stay abreast of changes that hit larger cities first, Rodman said.

"We also work with our local physicians to coordinate outreach clinics for patients. By sending specialty physicians to the rural areas, patients are more inclined to seek preventative medical treatment."

Specialists in ear, nose and throat diseases and conditions, cardiology and thoracic care, urology, neurology and neurosurgery and oncology conduct outpatient clinics in the hospital's service area, Rodman said.

Across town at St. Mary-Corwin, 3,144 out-of-town patients were seen between December 2007 and the end of November, according to spokeswoman Rochelle Kelly DeVargas. Another 5,755 out-of-town patients came to the hospital during that period for radiology and imaging services, including mammography.

Figures for the previous year totaled 10,382 nonresidents, but included those who came to the hospital for lab work. St. Mary-Corwin this year began sending pathologists to rural communities for blood sampling and testing, and "this change in procedure resulted in fewer rural admissions for lab work" in the period ending in November, DeVargas said.

Emergency services are the second-highest category for utilization by out-of-town patients at St. Mary-Corwin, with 3,061 in the year that ended in November, and 3,304 in the same period beginning in December 2006 through November 2007.

The remainder of the nonresident patient visits during the past year were for cardiology (563), oncology (352), general medicine (307), orthopedic conditions (295) and obstetrics (247).

The hospital also provides physical rehabilitation and stroke care, but specific figures for those services were not available.

DeVargas said the hospital provides numerous outreach programs in rural communities, for patients and providers.

Among the most important is training for first responders and clinic and hospital staff in emergency procedures, including specialized programs for pediatric and advanced cardiac life support, geriatric emergency techniques and many more generalized areas related to emergency and trauma care.

Pueblo Radiology Group (the group that is based at St. Mary-Corwin) recently started providing services at St. Thomas More Hospital in Canon City. A digital imaging team also provides services there as part of the two hospitals' relationship to Centura Health, a national organization that manages both hospitals.

Through its Southern Colorado Family Medicine Program, St. Mary-Corwin sends all 18 members of its annual physician-resident classes to outlying communities for monthlong rotations before they graduate.

"The purpose of the rotation is to allow the residents to experience firsthand the challenges and rewards of practicing medicine in a rural or underserved setting with limited medical resources," DeVargas said.

Many of them decide to stay in Pueblo or relocate to outlying communities in the hospital's service area.

Of the 186 family physicians who have graduated from the SCFM residency program, DeVargas said, 80 percent are practicing either in Pueblo County or in rural Southern Colorado communities.

"If it weren't for our program, many of those small towns would not have physicians," DeVargas said.

Residents from the program also staff the Los Pobres health clinic in Avondale as volunteers. Managed by Sister Nancy Crafton, the clinic serves migrant farm workers from throughout the Arkansas Valley.

Both Pueblo hospitals offer emergency air transport from the eight outlying hospitals in their service areas to Pueblo, as well as flights to hospitals in Colorado Springs and Denver for extreme cases that can't be handled here.

To see more of The Pueblo Chieftain, or to subscribe to the newspaper, go to http://www.chieftain.com.

Copyright (c) 2008, The Pueblo Chieftain, Colo.
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