Survivors of sexual assaults who live in rural areas sometimes must travel upwards of 4 hours to receive medical care and medical forensic exams. This can be difficult and often very hard on the survivor.
Providing telehealth resources in the survivor’s very own community, where they are more comfortable, can mean the difference between them seeking help or not. The U.S. Department of Justice provides grants to amplify the care for victims of sexual assault, improve the quality and approach of forensic examinations, and expand access to the proficiency of Sexual Assault Nurse Examiners (SANE) through telehealth technology for communities with restricted access to Sexual Assault Nurse Examiners. Telehealth can be used to improve care, access, and quality of these examinations. Pilot studies of telehealth sexual assault forensic examinations have shown that live telehealth services used in these instances is very promising.
Main Conditions and Areas of Funding
State/Tribal/Regional Demonstration Sites
Increasing the total number of highly trained and experienced SANEs and other medical forensic medical examiners provides an efficient and high-quality care flow for survivors of sexual assault. “Underserved” areas include tribal, rural, and other areas in need of SANE services/victim advocacy.
- Establish a network of highly trained and experienced SANEs to provide 24/7 support and guidance for medical providers who do not have the same training as SANEs. This will not only increase the confidence and retention of medical providers, but it will also improve the quality and availability of care for survivors.
- Incorporate the Quality-Caring Model© to guarantee that more sexual assault survivors are receiving patient-centered and trauma-informed care during their examinations. The Quality-Caring Model© is the theory foundation that SANEs use to form a caring relationship with the sexual assault patient to achieve the best possible outcome for both the patient and community. The model spells out four caring relationships (caring for the patient/family, caring for self, caring for others, and caring for the community) and eight factors of caring that provide specific categories of caring behaviors. These concepts, examples of these factors in action, the key principles of SANE care, and model videos used for training can be found in the link at the beginning of this bullet point.
- Ensure that the sexual assault survivors have access to a support person during the exam process. If this is a telehealth visit, the survivor should have a trusted friend or family member with them for the duration of the visit.
- Deliver ongoing sexual assault forensic examination support, education, and training to medical providers with limited access to these resources.
Technical Assistance Provider
- Provide technical assistance to proactively support sites, which may include rural and/or tribal communities (listed in section above), in building a robust support system of stakeholders who, through effective and multidisciplinary cooperation and outcome-driven plans of action, implement a survivor-centered approach to providing compassionate care to sexual assault survivors through telehealth technology.
- Provide diverse subject-matter and technical support, in consultation with Orphans and Vulnerable Children (OVC—if applicable), to improve the jurisdiction’s response to sexual assault. This includes identifying and meeting needs, creating and implementing policies across the health care structure, and applying evidence-based approaches.
- Facilitate ongoing peer-to-peer discussion, learning and collaboration among sites (looking to implement these services) in the same region and their partners within a given state/region or tribe, to promote problem-solving/innovation through the exchange of information, lessons learned, and new ideas.
- Strategically identify and capture relevant data and lessons learned throughout the peer-to-peer interactions. Once this information is collected and organized, share it with the public through your facility’s website and other modes to maximize the benefits of these discussions.
- Assist OVC and the other sites your facility is interacting with in connecting this project with other relevant federal, state level, or private foundations to ensure that your efforts are supported to maximize the outcomes and sustainability of these resources for sexual assault survivors.
The Texas A&M College of Nursing is cultivating two rural sites that will bind a telehealth platform with the ability to connect SANEs to rural providers on a virtual platform. This project has been expanded to Pennsylvania and Massachusetts with great success. The idea arose when it was noted that we needed technology with the ability to capture high-quality forensic photographs while sharing them with the remote SANEs in real time. This type of technology was previously unavailable to many rural and underserved hospitals due to a price tag of around $30,000. However, with the progression of chroma key technology, in-depth simulations of training centers with video overlays of explanations have become more widely available to nurses and other medical providers in underserved communities. Real-time communications on secure video networks are becoming attractive to health systems, as well as courts in rural communities across the nation.