Our Role in Building a Healthier State
Through creating and supporting programs, collaborating with partners throughout the state and adopting regional and national models, we focus on achieving six core objectives:
- Enhancing clinical care, practice support and professional development for rural and underserved health care providers and promoting professional retention and well-being
- Improving the diversity and distribution of South Carolina’s rural health workforce
- Facilitating research necessary to inform strategy, investment and health policy related to rural and primary care in South Carolina
- Increasing access to specialized services for rural and underserved primary health providers
- Promoting collaboration among state entities involved in rural health issues
- Increasing and enhancing rural health professions and interprofessional education opportunities in South Carolina.
A Growing Partnership
The center grew out of a partnership between the University of South Carolina School of Medicine and the state's Department of Health and Human Services. The USC School of Medicine established the S.C. Center for Rural and Primary Healthcare in 2017 in an effort to expand programs for training, recruiting and retaining primary care physicians in South Carolina’s rural and underserved areas as well as enhance service to rural patients.
The center is supported in its mission by an advisory committee with broad representation from key stakeholders supporting rural and primary health care in South Carolina, including the South Carolina Office of Rural Health, the South Carolina Area Health Education Consortium, the S.C. Department of Health and Environmental Control and the S.C. Primary Healthcare Association as well as state educational institutions and community representatives.
Through collaboration with rural communities and practices, the Improved CAre and provision of Rural access to Eliminate health Disparities (ICARED) project provides clinical services and practice support with a focus on innovative technologies. ICARED supports rural clinical practices through onsite primary care and subspecialty support, telemedicine, technical skills training and community engagement.
This program provides boots on the ground subspecialists, including pediatric subspecialists, maternal fetal medicine specialists, psychiatry specialists and adult cardiologists to augment the care being provided in the local community. Our current sites include Society Hill, Hartsville, Orangeburg, Sumter, Lancaster, Winnsboro, Aiken and Florence. We support primary care practices with teleconsultation for Hepatitis C treatment through our immunology center. We also support ultrasound training for rural providers and community-focused health programs through the FoodShare Fresh Food Box program.
Given that the primary care workforce across South Carolina is inadequate, especially in rural areas, the S.C. Center for Rural and Primary Healthcare established a loan program to increase the future rural primary care workforce pipeline. Students from all publicly affiliated South Carolina medical and health professions schools are eligible for this statewide program, which will launch with students entering state schools in 2018.
Loan recipients are required to commit to rural South Carolina practice in a primary care specialty (family medicine, general pediatrics or general internal medicine) or another critical need specialty (general surgery, OB/GYN or psychiatry) for each year of scholarship funds received.
Participants agree to return after residency training to practice in rural areas in South Carolina identified by the S.C. Center for Rural and Primary Healthcare through its research, analysis and evaluation. Students from South Carolina would be given first priority, but students from other states who commit to rural South Carolina practice are encouraged to apply. Other recruiting priorities include students with rural, underrepresented and/or underprivileged backgrounds. Students are eligible to enter the program during either their first year of medical school or prior to graduating from medical school. Because training in proximity to rural areas predicts future practice and family medicine training is more dispersed to these areas compared to other specialties, particular emphasis will be placed on recruiting family medicine physicians.
Utilizing existing data related to provider distribution, health care facility location, disease burdens, and health care utilization patterns across the state, the Research and Evaluation division is conducting a detailed analysis of rural health care resources in South Carolina to examine the interplay of factors in health care delivery and outcomes. Ultimately, this project will evolve into an up-to-date data warehouse of public-use data, aggregated and summarized to the local level, to be utilized by providers, policy makers and educators to alleviate delivery disparities within the state.
The division also supports the evaluation of other programs sponsored by the S.C. Center for Rural and Primary Healthcare. These include the ICARED program and collaborative grants focused on rural health innovations in collaboration with other health sciences schools and state agencies.
Kevin Bennett, Ph.D.
Rural South Carolinians are disproportionately affected by poorer health outcomes than residents in urban areas. In response, the Rural Innovations program provides resources and support to local organizations throughout South Carolina to tackle rural health problems at the community-level. And more broadly, the program is dedicated to investing in innovative solutions and best practices that can be spread and adopted by other rural communities and inform public policy.
The South Carolina Center for Rural and Primary Healthcare supports and manages the competitive Rural Innovations Program. The program identifies and supports innovative programs or strategies that address unmet needs or support efforts to improve rural health. Awarded projects focus on supporting health in rural communities through improving access to healthcare services; enhancing the health professions workforce; implementing services/programs that promote improved health outcomes for rural patients and residents; or integrating health care and community-based programs.
The center will launch a web-based information hub that will allow rural clinicians to collaborate, interact and exchange ideas and best practices. This resource will also support the center’s pharmacy extension service. Through this tool, we will provide enhanced clinical information and continuing education services to rural practitioners enrolled in the online learning community. This network will be supported by a medical librarian who will catalog discussion forums, distribute information from the center to rural practices and facilitate information exchange.
Extension services modeled after agricultural extension services have been proposed as an innovative solution to transform primary care. Recognizing that clinical pharmacists play an essential role on interdisciplinary medical teams, the center is establishing this program for a rural clinical pharmacy extension service providing access to a clinical pharmacist for each of the four S.C. AHEC zones. The initial pilot is underway, and we plan to expand to practices throughout the state to address challenging pharmacotherapy issues, disseminate important medication safety information and provide evidence-based recommendations for effective and high value medication use. This service will operate through the practice information hub.
Rural practices face unique challenges in enhancing office operations or recruiting staff with specific skills. To help practices meet these challenges, the center created this micro-grant program to disperse funds that can be used for infrastructure (ex. computers, software, system interfaces) or for physician, practitioner or staff development. We collaborate with the S.C. Office of Rural Health to administer this program.
Michele Stanek, M.H.S.
The S.C. Center for Rural and Primary Healthcare works to expand capacity for rural clinical training sites to increase medical student and resident interest in rural practice. We help develop infrastructure, physician support and model multidisciplinary practices at rural practice sites in the South Carolina Midlands and Pee Dee regions to support resident electives, student rotations and multidisciplinary health education for students.