2018 Pew Research Center report states, “People living in rural areas have longer travel times to the nearest hospital.” It’s not an earth-shattering revelation, by any means, but the details are interesting. According to the report, rural Americans live an average of 10.5 miles from the nearest hospital, while those in the suburbs live 5.6 miles away and those in urban areas are 4.4 miles away, on average. This translates to average travel times of 17 minutes, 12 minutes, and 10 minutes, respectively. These are just averages, and the report recognizes that averages “mask considerable variation in access within community types.”

Pew Research Center based these figures on a metric of “car travel time.” The report’s methodology didn’t account for communities that are not on a road system. When one is trying to get a national picture of access to healthcare, perhaps that makes sense. But when one considers the healthcare needs of Alaskans, this report demonstrates the problem of relying on national data to inform local issues.

Affordable, practical access to healthcare is a nut Alaska has been attempting to crack for decades, and some progress has been made. Innovative programs of traveling healthcare practitioners and significant improvements in telehealth show the healthcare industry evolves to meet the needs of residents.

But each region of Alaska has its own needs and potential solutions, and Southeast is a particularly interesting space, as it has both fewer and more connections to surrounding communities. Some Panhandle communities, such as Haines, are accessible by road: it’s about a fourteen-hour drive from Anchorage, assuming one has a passport. The “drive” from Wrangell to Anchorage is approximately the same as Wrangell to Seattle—roughly thirty-three hours—but both routes require the captain of one of the ferries that travel the Alaska Marine Highway to take the driver’s seat for a portion of the trip.

Southeast, instead of relying on travel outside of the community, has built up a network of health services within the community. The Southeast Alaska Regional Health Consortium (SEARHC) is a nonprofit working to do exactly that through 100 providers in twenty-seven Southeast communities. One of its newest connections was made in March, when it welcomed Rainforest Pediatric Care to its Care Network, expanding its pediatric care services in Juneau. As part of the agreement, Rainforest Pediatric Care moved from its previous location to the Ethel Lund Medical Center.

SEARHC President and CEO Charles Clement said of the partnership, “Merging Rainforest Pediatric Care with SEARHC is another step toward our mission to fill out our service lines toward a complete spectrum of healthcare offerings… We focus on new partnerships and mergers with likeminded organizations.”

One such organization was Alaska Island Community Services, which operated the Wrangell Medical center and formally affiliated with SEARHC in 2017; in 2018 SEARHC took over operations of the Wrangell Medical Center, the primary behavioral health, dental, and primary care provider for Wrangell.

Not all of SEARHC’s relationships are mergers; it has contracted with Dahl Memorial Medical Clinic, located in Skagway, to provide healthcare to SEARHC’s beneficiaries.

Dahl Memorial Medical Clinic is one of a handful of facilities that provide emergency care to those living or traveling in the Panhandle. It’s named after Dr. Peter Dahl, who answered an advertisement in 1925 for a doctor to serve in Skagway for a monthly wage of $250. When the clinic was named in 1968, it was after Dahl, who was Skagway’s longest serving doctor.

In addition to 24/7 emergent care, it offers a range of standard healthcare services year-round and houses visiting providers who offer services ranging from physical and occupational therapy to optometry, dentistry, breast cancer detection, and acupuncture, aromatherapy, and reflexology.

It also provides a limited selection of over-the-counter medications, an unusual service for a clinic/hospital but one that suits its community. “We know that sometimes certain items can be in short supply and, in a pinch, people need them sooner than later,” the organization states.

One of Southeast’s other emergency care providers is Bartlett Regional Hospital, located in Juneau. Juneau has a resident population of just over 32,000 people, but the hospital serves a 15,000-square-mile region, with approximately 55,000 people residing in its service area.

Bartlett Regional Hospital provides a full range of healthcare services, is licensed for a total of fifty-seven inpatient beds, and is a certified Medicare and Medicaid provider.

Providers in Southeast have pursued multiple projects in recent years to update their facilities and better serve their patients.

For example, the Ethel Lund Medical Center, a state-of-the-art facility, completed a large-scale renovation in 2021. Local contractor Dawson and architect NorthWind Architects worked on the project, which included renovations to the lobby, reception area, waiting area, physical therapy room, ICT (information communication technology) areas and offices, pharmacy, lab, phlebotomy area, library, work rooms, and mechanical mezzanine.

In February of 2021, SEARHC completed construction of a new Wrangell Medical Center, which “married a new critical access hospital and long-term care with the existing [Alaska Island Community Services] Clinic to create a 44,500-square-foot healthcare campus,” according to the nonprofit.

In July of 2021, SEARHC entered into an official Joint Venture Agreement with the Indian Health Service to construct a facility to replace Mt. Edgecumbe Hospital, which is the oldest hospital in the Indian Health Service system. The new twenty-five-bed critical access hospital will be located in Sitka.

The Petersburg Medical Center is also taking the long view and making plans to build a new facility. The original Petersburg Hospital was built in the late ‘50s and now serves as the Long-Term Care wing. The hospital was expanded in 1984, and a clinic was added in the mid-‘90s. Essentially, “The basic infrastructure of the building is thirty to fifty years old,” according to the medical center. Jensen Yorba Lott, a Juneau architecture firm, assessed the facilities and found that the “majority of the systems, components, and finishes have exceeded or are near the end of their service life and should be replaced.” Petersburg is working on a plan for a new facility and in fact received $8 million from the Infrastructure Investment and Jobs Act for the construction of a new hospital.

To better accommodate far-flung clients, healthcare providers in Southeast have found multiple solutions. Bartlett Regional Hospital “expanded its pulmonary rehabilitation program to include a fully remote option for patients who suffer from long-term effects of COVID-19 or chronic obstructive pulmonary disease,” which it announced in May. The rehabilitation program includes exercise training and education on managing lung disease and developing healthy habits. “The COVID-19 pandemic has highlighted the increased need for delivery of virtual health care, particularly for patients with preexisting chronic lung disease who, as a result are at an increased risk of severe COVID-19,” a release from the hospital states. “Further, telehealth can help to reduce health disparities and barriers to care, such as lack of access to transportation and proximity to specialists due to geographic isolation.”

Since geographic isolation is more the rule than the exception in Southeast, SEARHC has a Patient Travel Office, which helps their clients who need emergency travel—and meet the eligibility requirements—via a 24/7 on-call travel coordinator. SEARHC also provides courtesy shuttle services to its medical campuses in Sitka and Juneau for those who need non-emergent medical travel assistance.

And for those who need to travel to the Mt. Edgecumbe Medical Center in Sitka for procedures that require little to no hospitalization, SEARHC established its Patient Housing Facility. According to SEARHC, “Our 7,820-square-foot short-term housing facility offers a safe, comfortable place to stay for as many as thirty-two patients or family members.” Two of the double-occupancy rooms at the facility are fully ADA compliant.

Better than traveling is finding ways to bring healthcare into the community. Through its Care Network partnerships, SEARHC has medical facilities in Klawock, Hoonah, Gustavus, Pelican, Kasaan, Haines, Hydaburg, Kake, Klukwan, and Angoon, all of which provide select medical services. For example, the Alma Cook Health Center in Hydaburg provides primary care through an in-resident certified nurse practitioner and behavioral health, dental, and physical therapy at set times on a weekly or bi-weekly basis, while the Jessie Norma Jim Health Center in Angoon has three medical professionals on staff to provide primary and specialty care and radiology, as well as offering pediatric care through a traveling pediatrician.

SEARHC also organizes seasonal clinics at Coffman Cove, Edna Bay, Naukati, Port Protection, Point Baker, Whale Pass, and Excursion Inlet. Many of these seasonal and year-round facilities serve all patients regardless of their ability to pay, based on a sliding scale.

Being flexible is par for the course for healthcare providers in Southeast, who have built up their practices and facilities purposefully to accommodate the communities they serve. According to Bartlett Regional Hospital, to meet it’s vision to be the best community hospital in Alaska, “We choose to do our best and work with a commitment to continuous improvement.”