Rural residents in need of health care face many challenges. In 2009 the Leona M. and Harry B. Helmsley Charitable Trust created the Rural Healthcare Program to improve access to and quality of care in areas of the upper Midwest challenged by health care workforce shortages and low population density. The program has focused its efforts on telehealth in seven upper Midwestern states. Since 2009 the Rural Healthcare Program has approved $22 million in grants to eighty-five rural hospitals to implement eEmergency services. The service's videoconferencing technology connects rural emergency department staff with emergency physicians and nurses located at the service's "hub." Initial analyses indicate that eEmergency has helped participating rural hospitals increase patients' access to specialists, increase the use of evidence-based treatment, decrease time to transfer a patient to a facility able to provide a higher level of care, and reduce unnecessary patient transfers. This article describes the health care challenges rural communities face and the telehealth projects supported by the Helmsley Trust's Rural Healthcare Program.
Integrated marketing communications] underpins the belief that marketing creates value by building brands, nurturing innovation, developing relationships, creating good consumer service and communicating benefits. [range right] Gilligan & Wilson (2009: 3). tools (Du Plessis et al., 2010) but these definitions have evolved notably over the last two decades. According to Baker (2003), the watershed between the production/sales approach to business and the emergence of a marketing orientation was probably best illustrated with the publication of Theodore Levitt's article 'Marketing myopia' in 1960. Seen in the 1990s as a marketing concept used for sales promotion, product publicity, events, sponsorships and direct marketing (Du Plessis, Bothma, Jordaan & Van Heerden, 2003), the marketing concept was articulated as reflecting the necessary characteristics of modern marketing, emulating the creed of modernism in general. In the 21st century it is seen as a relationship-building domain with personalised and integrated customised messages aligned with the corporate brand of the organisation. IMC in the 21st century is characterised by a postmodernist perspective in a market where strategies and tactics are needed to create and sustain a competitive advantage (Proctor & Kitchen, 2002). Today it is accurate to say that IMC is a newly emerging discipline with both a managerial orientation and a business philosophy, and one that has been affected by a postmodernist perspective. Nevertheless, in the literature there are contradictory viewpoints on IMC in the 21st century. This is primarily due to a lack of consensus on what IMC implies in practice. Some see it as replacing the traditional above-the-line and below-theline approaches with a through-the-line or zero-based approach, while others view it holistically, either in terms of a 'skin-deep' integration of messages or of a comprehensive plan that evaluates the strategic role of a number of communication disciplines (such as advertising; direct response; sales promotion; and public relations) needed to achieve synergy (that is, when the whole of the promotional effort is greater than the sum of the parts) (Schultz & Kitchen, 2000).
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