3 Ways Telehealth Can Improve Rural Health Care
“Right now, the rural health situation is in trouble,” says Brad Gibbens, acting director and assistant professor in the Center for Rural Health at the University of North Dakota School of Medicine. “And COVID has made it worse,” he adds, highlighting staff shortages and high rates of disease.
Telehealth, however, can help fill some of the gaps in rural health care. Here’s how:
1. It makes it easier for patients to access doctors and specialists
One of the most obvious ways for telehealth to bridge the healthcare gap in rural America is to increase patient access to providers. There are about 40 primary care physicians per 100,000 people in rural communities, according to the National Rural Health Association. In urban areas, the ratio is 53.3 per 100,000 inhabitants.
The disparity is even more pronounced when it comes to specialists. In rural areas, there are about 30 specialists per 100,000 inhabitants; in urban areas, this number climbs to 263 per 100,000 population.
It’s no surprise, then, that about a quarter of rural adults have to travel more than 31 minutes to get to a doctor’s office for specialist care, according to the AARP report. Calling a doctor – even one hundreds of miles away – takes seconds, however.
Then there’s the convenience factor of a virtual tour, especially for adults with limited mobility and for those who live in harsh climates. “If you don’t have to get in the car when it’s 20 under zero to see a vendor and walk on the ice, and you can have the exact same thing in your living room, people appreciate that,” said Gibbens of North Dakota.
2. It can advance chronic disease care
Monitoring patients with chronic diseases, such as high blood pressure and diabetes, is another way telehealth can improve health care in rural areas, where the rates of many diseases exceed the national average, according to AARP research.
Patients can take their blood pressure or blood sugar at home, for example, and send their numbers to a team of healthcare providers who can then adjust medications and other treatments based on the data received, says Saurabh Chandra, chief. of the Center. for telehealth at the University of Mississippi Medical Center.
This type of patient monitoring has resulted in reduced hospital readmissions and fewer emergency room visits. At the same time, remote monitoring educates patients and allows them to “learn more about their medical condition” and “better control their disease,” which translates into better patient outcomes, Chandra explains.
“When people think of telehealth, especially during the pandemic, they think of audio-video capabilities. And that’s part of it, but there are other modalities, ”he adds.
3. It helps rural doctors to provide first-rate health care
Physicians in rural areas, many of whom are general practitioners, can also benefit from telehealth, says Jan Probst, professor and emerita director of the Rural and Minority Health Research Center at the Arnold School of Public Health at the University of Carolina from South. If they have a patient with a complex case, for example, they can work with a specialist from an urban medical center or an academic research institute to determine the best treatment.
This approach supports “the capacity of the rural practitioner to provide high quality patient care,” says Probst, highlighting the successful model of the ECHO project. And it’s been shown to improve both patient outcomes and physician expertise.
Additionally, rural hospitals and clinics can use telehealth to connect with specialists to provide rapid care in situations where time is of the essence and transferring a patient is not an option. For example, a team of neurologists can video connect with emergency physicians in a remote location to help diagnose and treat a stroke quickly, reducing the risk of widespread damage and long-term disability.
Telehealth is not the only answer to rural health challenges
While telehealth can increase access to life-saving care – and make that care more convenient – it is not a “silver bullet” to solve all of rural America’s problems, Gibbens says.
For starters, about a fifth of rural adults do not have access to high-speed internet, according to the AARP report, and rural adults aged 70 or older with lower incomes and poorer health are least likely to have access to it.
Beyond that, “not everyone even has access to a library that has computers,” says Teresa Keenan, director of health and safety research at AARP. “If you don’t have access to a computer at home and you don’t have access to a computer in your community, telehealth won’t be the solution for you,” she says.
In addition, a significant portion of AARP survey respondents do not know if their doctor offers telehealth or if their insurance covers it. As geographic restrictions and reimbursement requirements for telehealth have been relaxed during COVID, “the question would be whether this continues if we ever get to the other side of the pandemic,” Keenan says. The return to pre-pandemic regulations could make it more difficult for patients and providers in rural areas to connect with specialists in the first place.
Other barriers to telehealth include concerns about confidentiality and medical errors, according to the AARP report. In addition, a number of respondents (around 40%) expressed skepticism about the possibility of solving their health problems virtually.
Telehealth is unlikely to ever trump face-to-face care ever, says Chandra. Rather, he sees the use of telephones, video and other technologies as a bridge to fill in the gaps in the system. “I think they can both work together to bring the best results for the patient,” he says.
Gibbens adds, “I don’t think there is one answer that solves everything, but I really do think telemedicine is a big step and has a major impact on health and access to health.