ACCOMACK – Riverside Shore Memorial Hospital serves many rural and isolated areas on the Eastern Shore of Virginia. Delivering medications to patients in a timely manner often is a challenge.
Nick Chuquin, president of the hospital, said there can be delays of up to five days to start a medication treatment.
“When you’re looking at antibiotics or steroids, even breathing problems, that’s not okay in today’s age,” he said.
Help is on the way thanks to a partnership among the hospital, DroneUp, Virginia Institute for Spaceflight and Autonomy at Old Dominion University, the Accomack-Northampton Planning District Commission, and the Virginia Innovation Partnership Corporation.
The group was awarded a grant from the U.S. Department of Transportation to develop ways to improve medical deliveries with the use of drones. There are two phases: the first for proof of concept and the second for implementation.
“We are in what I would call Part II of Phase I,” Chuquin said, adding Part I was community engagement.
When Chuquin first heard of the project, he immediately thought of Tangier Island, which is in the middle of the Chesapeake Bay and has a shrinking population. Riverside does have a physician’s assistant who lives on the island, but when a prescription is needed, it is sent to a pharmacy in Maryland. By the time someone can go there, pick it up and then deliver it to the patient, precious time is lost.
“It’s like what can we do to improve,” he said.
There are similar obstacles in Accomack County, where the hospital is located, and adjoining counties. Much of the population lives near the water, far off U.S. Route 13, down in necks that are difficult to get to, where postal service doesn’t reach. For many, the only way to get mail is at a post office, and those people often have transportation issues.
In talking with Sally Hartman, the senior vice president of strategic initiatives at Riverside, Chuquin thought the Eastern Shore was a perfect spot for the program.
“We’re isolated, and water on both sides,” Chuquin said.
So how to get started?
For legal and logistical reasons, controlled substances or medicines that are temperature sensitive were not considered for delivery. The hospital, which must conduct a Community Health Needs Assessment (CHNA) every three years, looked at its most recent results for guidance.
“We have a lot of hospitalizations that are caused by (chronic) heart failure, and CHF really escalates when your hypertension is not controlled,” Chuquin said.
That is where they started. By providing the medicine in a timely manner and having follow-up procedures to make sure patients are taking their medicine, it’s possible to lower that blood pressure.
“Then we’re reducing CHF hospitalizations and really, in essence, truly improving the health of our community,” he said.
If that proves to be the case, expansion to other medications isn’t far behind.
In the next few months, Chuquin is hoping there will be test deliveries within a three-mile range of the hospital. They have tested within one mile. The target date for trips to Tangier Island, about 70 miles away, is the end of the year or beginning of 2024.
“That’s a long one,” he said. “Seventy miles is a long way when you’re going on battery power and having to then turn around and come back.”
If that works, medications and supplies can be delivered to the island more often than the current schedule of just two or three days a week.
One of the biggest challenges Chuquin sees is convincing the public this is a good thing. When some people think of drones, they immediately think the accompanying cameras will be used for spying on people. He said that’s not the case.
“That camera’s only used to verify location and safe drop of the box. Once it flies, it is not really doing much,” he said. “Community acceptance is going to be a little bit of a challenge.”
He noted there are countries in Africa that have been doing drone delivery for medications and blood products in rural areas.
“So, it is established a little bit out there,” Chuquin said.
He’s also excited about all the possibilities outside the delivery of medicine. Hospital officials have had discussions with EMS personnel.
“When it is up and running, could we deliver Narcan to an overdose faster than EMS could get there in rural areas?” he said.
The same with a hunting accident. Can a drone deliver a stop-the-bleed kit faster to someone in the middle of the woods?
“You’re talking about minutes could save a life, right?” he said.
He admits that is way down the road, and he doesn’t want to get ahead of himself.
“Let’s deliver the first medication and then go to the second one and expand the length of the flights,” he said.
While some immediate effects will be seen, Chuquin said following the data and tracking the impact on the patients is important. The hospital will be able to see what medications are being delivered, who’s taking the medicine, who’s refilling it, and if patients are refilling their medication in a timelier manner, which indicates they are taking it.
“Are we actually lowering blood pressures? Are we lowering hospitalizations for CHF? Because that is where the key is,” he said. “But that long-term change in a health status of a population, that takes time.”
Chuquin also stressed this is a team effort. By no means is Riverside doing this alone.
“Every single one of our partners immediately was like, yes, absolutely, we can do this. And the great thing is that they have the same vision,” he said. “It’s a cool process, great that we’re doing this innovation, but it’s wow, we can actually improve care, we can improve patients’ lives by doing this.”
If it works here, Chuquin said who’s to say it can’t work in other areas of the state or country? Or for other industries?