Rural Health

Jan 24 2023

Why Does Telehealth Access Matter for Rural Broadband?

One-quarter of Americans live in rural areas, but fewer than 10% of U.S. physicians practice in those communities. This shortage of healthcare professionals in rural areas of our country restricts access to healthcare by limiting the supply of available services.

Residents of rural communities deserve the same quality of care to which their metropolitan peers have access. To compensate for this resource gap, healthcare providers are extending telehealth services.

But these efforts are coming up against an additional resource gap — broadband internet connectivity.

Rural broadband connectivity is essential for telehealth expansion, but of the 61 million people residing in rural areas, only 58% of adults have a reliable, high-speed broadband connection at home. (Compare this to 67% in urban and 70% in suburban areas.)

The debate is no longer whether telehealth access benefits residents of rural communities but what is the most effective and impactful way to connect rural communities to the broadband services necessary to provide telemedicine.

Let’s examine the connection.

Telehealth Expansion Necessitates Broadband Expansion

The lag in broadband connectivity experienced by rural communities comes in many forms, including:

Less robust or fewer types of broadband infrastructure available,
High cost of installing broadband infrastructure, and
Unreliable broadband speeds (required to enable innovations in healthcare).

A telehealth provider sits on a green couch with a laptop sitting on a table in front of her.

A recent study found that only 38.6% of the people who live more than a 70-minute drive from a primary care physician subscribe to an internet connection capable of handling telehealth services.

To expand the reach of telehealth services into non-metropolitan communities, we must begin by laying the broadband infrastructure necessary to offer those services.

Broadband Expansion Empowers First Responders

The expansion of broadband coverage benefits emergency responders as well as the citizens they serve.

First responders are essential to the protection of public health and safety. When they enter rural communities, they require reliable connectivity to communicate with one another and seek additional resources for response.

A blue 6-pointed asterisk sign with the word AMBULANCES on it.

FirstNet has created a predictable network of connectivity in rural communities to empower first responders. FirstNet is a nationwide high-speed wireless broadband network deployed on 20 MHz of high-quality spectrum that is constantly evolving to meet public safety needs.

When not in use for an emergency, the FirstNet network is used for other commercial purposes (though first responders will always have priority over others during an emergency).

Two benefits of the FirstNet and telehealth connection are:

Enhanced communications for first responders to dispatch an ambulance to a location once the call is received by the consumer/citizen (fairly weak connection).
The network provides high-quality wireless service to many previously unserved rural areas across the US. This wireless broadband can support telehealth activities like online doctor appointments when not in use for an emergency.

But local communities often lack the resources necessary to bring broadband to their areas. That’s where the federal government can help.

Federal Expansion of Broadband Connectivity and Telehealth Access

Recognizing the need for rural communities to 1) improve broadband access and then 2) establish telehealth provisions, various federal programs have increased opportunities and support for public health organizations to establish broadband connectivity.

The US Capitol Building at sunset, where federal programs have been created to aid rural residents access affordable broadband internet.

There are a number of federal programs providing pathways to affordable broadband. Below are a few that emphasize rural broadband access:

The Office for the Advancement of Telehealth is working to improve health care in rural, urban, and underserved communities. In particular, their telehealth grant programs promote and advance telehealth services in rural areas.

The FCC’s Connect2Health Task Force (C2HFCC) is engaged in ongoing efforts to provide expert input and information to stakeholders from a variety of states throughout the country about the importance of broadband and broadband-enabled technologies (e.g., telemedicine, remote monitoring, etc.) in health care at various telehealth resource center annual conferences.

The Rural Health Care Program (which the FCC also oversees) provides funding to eligible healthcare providers for telecommunications and broadband services necessary for the provision of telehealth. This program aims to improve the quality of healthcare available to patients in rural communities by ensuring eligible healthcare providers have access to telecommunications and broadband services.

The National Map of Telehealth Resource Centers provides assistance, education, and information to organizations and individuals who are actively providing or interested in providing health care at a distance.

The Rural Health Information Hub has created a list of current efforts providing telehealth funding for rural healthcare providers.

The American Connectivity Program (ACP) is a nationwide initiative that helps households afford the broadband they need for work, school, healthcare, and more.

But access isn’t the end of the story.

Digital Literacy’s Impact on Telehealth

Digital literacy refers to a user’s ability to navigate information and communication technologies to find, evaluate, create, and communicate information. This skill is critical when navigating telehealth — like every other skill set, we can teach digital literacy!

It is not enough to simply equip rural communities with broadband infrastructure. To maximize the impact of broadband expansion, users need to understand how to actually use the internet.

A pair of hands holds a tablet. The screen reads CONNECT and shows different social media icons.

Several initiatives are already in place to improve digital literacy, particularly in rural areas. And some digital literacy programs focus on serving marginalized communities in rural areas.

For example, the elderly community are frequent healthcare users and can benefit significantly from improved access to telehealth, but only if they feel confident and comfortable navigating the resource online.

While telehealth and telemedicine are on the upswing in rural America, there’s still much work to be done before equitable access is the norm. So how can you help?

Bringing the Benefits of Telehealth to Rural America

Telehealth is an effective way to combat the harm of reduced resources in rural areas, but only if those communities are connected to the Internet. Establishing robust broadband connectivity in rural communities will strengthen telehealth services that have a direct, positive impact on rural residents.

But getting to a place where all Americans can access broadband and services like telemedicine will take continued care and effort. That’s where you come in.

Do you or your organization work in telehealth?

Do you work to bridge resource gaps like broadband connectivity in rural communities?

Have you struggled with or benefitted from these services as a consumer?

We would love to hear from you and continue the conversation. When we get together to talk about the impact of programs closing the urban-rural healthcare divide, it helps communities understand successful programs and program pitfalls, among other benefits.

Join in the conversation on Twitter or in our LinkedIn or Facebook groups.

Dec 13 2022

Telehealth and Telemedicine: What Are the Benefits for Rural Patients?

Individuals living in rural communities want to stay there. And why not! Ask most rural residents, and they’ll have a long list of the reasons they love their rural community.

And nearly 80% of rural small business owners agree the quality of life and cost of living is much better in rural areas, according to the U.S. Chamber Technology Engagement Center.

All this is true despite the ways rural communities quantitatively lag behind their metropolitan counterparts — for example, access to healthcare providers like hospitals, primary doctors, and specialists.

Access to healthcare is necessary for a thriving community, and residents in rural areas deserve equal access to quality healthcare. So how do rural areas overcome any gaps in healthcare access?

Telehealth offers impactful methods of providing healthcare and outreach to rural communities.

What Is Telehealth?

The telehealth definition used in this article is the delivery of healthcare to individuals over a high-speed internet connection.

What is telemedicine? A healthcare practitioner speaks to a patient via videoconferencing. The patient is holding her hands up to her throat as she describes her symptoms.

In addition to having virtual meetings with healthcare providers, other types of services include:

telemedicine (the provision of remote medical care via the Internet and video conferencing),
electronic medical record keeping, and
portal technology and videoconferencing.

Remote health monitoring tools such as wearables and biosensors that track and report personal health information have also become commonplace for remote health care.

Combined, these methods of communicating with healthcare providers help close the rural-urban healthcare access divide.

Before we examine the benefits of telehealth in rural areas, let’s talk about rural healthcare in general.

What Does Healthcare Look Like in Rural Communities?

Regardless of community size, access to routine healthcare and preventative care have long-term, positive impacts on a person’s health. Additionally, when healthcare resources are commonplace, a community flourishes.

The outside of a rural hospital, showing the brick facade and vehicles lined up at the entrance.

Rural communities, however, are experiencing barriers to commonplace healthcare provisions. Unfortunately, hospitals across rural America are closing at an alarming rate.

According to the U.S. Government Accountability Office, over 100 rural hospitals closed from 2013 to 2020, forcing people living in those areas to travel farther to get the same healthcare services — about 20 miles farther for services like inpatient care and double that for services like alcohol or drug abuse treatment.

People living in rural communities have limited access to healthcare institutions, travel long distances to receive care, and (because of these factors) often delay needed care until after they have a health emergency. The cost associated with traveling for medical care puts an additional burden on rural patients that may discourage them from seeking care.

Limited access to healthcare can result in poor health outcomes and is a social and economic burden for both the patient and the healthcare system at large.

Advancements in telehealth – and expanding those services to rural communities – can be used to make up for expanding gaps in health services.

What Are the Benefits of Telehealth in Rural Communities?

People in rural America are growing increasingly comfortable with telehealth and telemedicine.

A woman sits beside a child on a couch, holding a thermometer. There is a tablet sitting on the table in front of them as they wait for a telemedicine appointment.

Telehealth is already an effective approach for doctors to monitor their patients’ chronic conditions, like heart or lung disease. Better monitoring can improve quality of life and reduce hospital admissions and deaths from chronic diseases.

Rural hospitals have fewer resources to provide their patrons, such as specialists or outpatient programs. But telehealth empowers rural hospitals to partner with larger hospitals, work with established online programming for outpatients, and connect to specialists in other communities to make up for these gaps in service.

Telehealth resources facilitate communication between hospitals, which impacts patient care through communication, recommendations for ongoing care, organ donation, patient transport, and more.

The CDC recognizes telehealth as a critical resource for healthcare, both now and in the future, especially for providing care specifically to rural Americans. Because of this, the organization offers various telehealth services targeting common health issues common to rural residents.

One example is the CDC telehealth stroke services which connect hospitals in rural areas with telehealth doctors and specialists outside of their communities to improve the outcomes of patients receiving treatment after experiencing a stroke.

In an effort to expand telehealth to institutions, the CDC has created case studies (HabitNU, Inova, and Inspera Health) that describe successful program structure, technologies used, and implementation steps, along with lessons learned.

But every rural resident isn’t comfortable with talking to their doctor without being face to face.

Why Are Rural Residents Wary of Online Telehealth?

Telehealth is a relatively new healthcare field, and some patients are suspicious of its drawbacks.

Two men, a doctor and a patient, sit in an examination room looking at an X-ray.

According to one review of telehealth interventions and outcomes across rural communities, disadvantages of telehealth interventions included having telemedicine visits with unknown providers and technological issues such as loss of connectivity and limited Wi-Fi access.

Rural residents place a high value on members of their own communities and can be wary of meeting with unfamiliar healthcare providers.

However, acceptance of telehealth during the pandemic accelerated to the point that many barriers to telemedicine use – including trust – may have begun to disappear. Furthermore, telehealth is now available almost everywhere, meaning patients can connect to primary care providers with whom they have an established relationship!

However, along with the other limitations and challenges of telehealth, we can’t forget that the foundational requirement of affordable, accessible broadband and cellular connectivity remains an obstacle.

So, where do rural areas go from here?

Telehealth in Rural Areas: What’s Next?

As telehealth improves, individuals across rural America are empowered to seek healthcare providers more often, preventatively, and consult specialists that meet their unique needs.

One review concluded that telemedicine in rural areas decreases travel time, improves communication with providers, increases access to care, increases self-awareness, and empowers patients to manage their chronic conditions. These benefits are critical to residents in rural communities.

Rural providers also benefit from telehealth as institutions are empowered to expand their provisions by connecting their patients to telehealth resources, decreasing missed appointments and patient wait times, as well as improving patient care quality.

While limitations of telehealth exist, the field is quickly improving and expanding patient care across the country, with unique benefits available to rural communities. Conversations about the impact of programs that close the urban-rural healthcare divide help communities understand successful programs and program pitfalls.

Do you or your organization work in telehealth? What is your experience with telemedicine? We would love to hear from you and share additional resources. We invite you to share your experiences by commenting here and visiting us on Twitter (@RuralRISE).