Serving Rural Patients for Telehealth

Individuals living in rural U.S. communities account for 15 percent of the population and have particular and significant challenges to health and wellbeing. Compared to people living in other areas, rural populations are older, have higher rates of poverty, are more likely to have disabilities, and are less likely to be employed. These and other factors result in poorer health outcomes—including a higher risk of death due to heart disease, cancer, stroke, chronic respiratory disease, and unintentional injury—than non-rural populations.

While access to high-quality health care is of utmost importance, rural areas encounter barriers including consistent provider shortages, hospital closures, and lack of proximity to services. Telehealth allows health centers serving rural areas to expand services, integrate primary care with subspecialty services, and improve care management.

Serving Rural Patients with Telehealth, developed by JSI, is an overview of the challenges to providing telehealth services in rural communities and proposes short- and long-term strategies to improve it, including the following examples:

Short-term:

• Accessing broadband through public Wi-Fi: People with limited access to broadband at home can often access the internet through libraries or schools. During the public health emergency, many libraries have found creative ways to keep residents connected, such as providing Wi-Fi all day, offering drive-in Wi-Fi spots, reserving hot spots, and even using library vehicles to transport hotspots to neighborhoods that have limited broadband access.
• Making the most of limited broadband: Some rural residents have functional but limited broadband, such as less bandwidth or limited speed. To support real-time audio/video telehealth, patients can be encouraged to make the most of the broadband they have, including moving as close to the wireless router as possible and scheduling visits when others in the house are not streaming anything. It may also be helpful to plan for internet instability and connect the phone separate from the video, so the call can continue even if the video is lagging or stops working.

Long-term:

• Building partnerships: Rural health care providers should consider partnering with Medicaid officials and private insurance representatives. Partnering with payers can lead to funding for pilot programs and solutions to high-cost challenges.

This resource was developed for and made available through the HITEQ Center. HITEQ helps federally qualified health centers implement and optimize electronic health records, health information technology, and telehealth.