Leadership at Fairview Range Medical Center initiated the project by approaching leadership of the University of Minnesota.

Department of Anesthesiology at the University negotiated a contract to provide medical directorship of the operating room and medical directorship of perioperative medicine services. The current medical directors of both services at the University of Minnesota were appointed dual roles in each site.

Medical Directors have monthly visits via scheduled air service to meet administrative, surgical and medical leadership.

Development of a robust tele medicine program to provide preoperative, intraoperative and postoperative anesthesia care with video technology.

Collaboration between rural hospitals and academic medical centers should facilitate provision of the best possible evidence based perioperative care for the largest surgical population. We have demonstrated the ability to use multiple platforms synergistically to collaborate on all facets of perioperative care. The cooperative venture has been well received by all providers and has energized care in both hospitals. Similar collaborations could greatly improve care and value for the 20% of the population that receives care at rural hospitals. While telemedicine has been described to assist preoperative assessment, this to the best of our knowledge is one of the only programs that offer real time intraoperative and postoperative anesthesia consultative management via tele medicine.