Dartmouth-Hitchcock Medical Center is partnering with nonprofits and state labor departments to capitalize on technology driven changes in health services.

The hospital will train and hire 20 medical assistants and 10 pharmacy technicians to staff a virtual clinic that will review medical information gathered from patients remotely.

The hospital is working with Vermont HITEC, a nonprofit education center that tailors job-training courses to meet existing demand from employers.

Dr. Ethan Berke, director of primary care and population health at Dartmouth Hitchcock, says the hospital will use the program to expand options for patients.

"We're reverse engineering these positions to fit the needs of our primary care system," Berke said.

The cross-border training program has support from vocational training nonprofits in the Granite State as well as Vermont and New Hampshire labor departments and the U.S. Department of Labor.

The virtual clinic will allow Dartmouth-Hitchcock to increase use of remote medical sensing equipment for patient care. The devices will monitor the patients' medical conditions remotely and will reduce the need for patients to visit the hospital.

Telemonitoring and telehealth communications have the potential to reduce hospital admissions for patients with complex or chronic conditions by making it easier for people to share their medical information with clinicians, according to hospital officials.


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Dartmouth-Hitchcock's virtual clinic will use telemonitoring and telehealth to supplement existing services. Telemonitoring remotely tracks patients' health indicators such as blood pressure or heart rate and "telehealth" allows medical providers to provide health-related services through telecommunications technology.

The technology makes it possible for a doctor to send information to clinicians without a patient visit. The virtual clinic could also monitor vital signs and reduce home health costs for seniors by only sending a nurse when the data indicates there is a problem.

"We're asking 'why does the patient always have to come to us, and are there some things that can be done remotely that will add value or improve outcomes,'" Berke said.

Berke said patients who use the virtual clinic would have the same privacy protections as people who visit the hospital.

Vermont passed a law this year that requires Medicaid coverage for telemonitoring by home health agencies or other qualified providers. The law is an acknowledgement of the potential for telecommunication technologies to improve health care delivery.

Dartmouth-Hitchcock is working with Vermont HITEC, which will provide a 10-week training seminar for 30 applicants to the program. The deadline to apply is July 27.

Gerry Ghazi, president of Vermont HITEC, says applicants do not need prior experience in health care or telecommunications to participate in the training.

"We tell the employer that we guarantee the trainee will have the competency to fill the position when they complete the course," Ghazi said. "Every successful graduate has a job the next day."

Vermont HITEC works with the departments of labor to promote the trainings through direct mailings, state job link sites and notices on unemployment sites.

After an orientation that includes and aptitude assessment, there is an initial round of interviews with Vermont HITEC. Following a second round of interviews with the employer, candidates are selected to participate in the training course.

The trainings are unpaid, but the organization can offer support services to help people complete the course. If a participant does not complete the course the position goes unfilled.

"In the end it takes an individual that really wants to improve themselves," Ghazi said. "Most of them in a case like this don't have any health care experience."

Starting pay for the virtual medical assistant and pharmacy technician positions will be $14 an hour with potential to earn up to $17 an hour after a one-year apprenticeship. The positions all include a benefits package.

Since 1999, Vermont HITEC has helped roughly 1,000 people in Vermont and the Upper Valley find jobs through targeted trainings.