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How telehealth is supporting rural practices’ role as a community center


Since there are simply too few doctors in far too many rural communities across the country, telehealth can help physicians ensure targeted care for everyone.

According to the Census Bureau, there are 60 million people who live in rural communities, but only nine percent of U.S. physicians practice in these areas. 

The physician shortage is only the first barrier to quality care access in rural areas. Others include logistics of delivering emergency medical services, lack of trauma centers, and cost-on both patients and physicians-to receive and provide quality care. In fact, a recent study by the Centers for Disease Control and Prevention found that nonmetropolitan areas have a higher percentage of deaths from the five leading causes-cancer, heart disease, stroke, chronic lower respiratory disease, and unintentional injuries. Much of this is due to lack of the appropriate resources and care access. 

Physician practices in rural areas are a critical part of keeping these communities healthy, as they oftentimes are the only access to care for miles. But since there are simply too few doctors in far too many rural communities across the country, telehealth can be employed to support physicians in providing targeted care for everyone. 

Addressing gaps in rural America

It’s projected that more than 70,000 of deaths in 2014 in rural areas were potentially preventable, including 25,000 from heart disease and 19,000 from cancer. But oncologists and cardiologists, to start, are not always easily accessible.

With the advent of telehealth technology, rural physicians now have a tool to provide a higher level of care to their patients-most significantly, specialty care. Rather than sending patients off to a distant specialist and then begging for faxed data from the visit, telehealth allows physicians to both set up and attend the specialist visit themselves with almost instant access to test results through their EHRs. As patient demographics change to include more tech-savvy generations and broadband access becomes increasingly available, mobile applications have become a viable option for rural care. 

Telehealth also accommodates the unique circumstances of rural residence. Quick and efficient access to in-demand specialists via telehealth means that patients can avoid hours-long drives that take them away from their jobs or families. For example, a telehealth program currently running in two rural Georgia schools enables nurses to coordinate student care with local physicians and Atlanta specialists. Students don’t have to miss school and their parents don’t have to take off time from work.

Ultimately, telehealth technology gives overworked rural physicians access to a wide range of resources that can aid them in providing specialized care. Consider the following examples: 

● Chronic care management is often a challenge in rural towns, causing higher costs and health consequences. Telehealth offers physicians the opportunity to take a team approach. A care team for diabetics, for example, might include remote access to a nutritionist, behavioral therapist, pharmacist, and medical specialist.

● Emergency care can substantially benefit from life-saving interventions by remote specialists. The value of real-time access for evaluations and consultations on stroke victims has been well proven, and has even spurred legislation such as the Furthering Access to Stroke Telemedicine Act (FAST Act). With each successful use case, telehealth becomes a stronger option for a broader range of conditions.  

● Behavioral health is another area where telehealth can have a critical impact, giving physicians and their patients access to scarce and often remote resources. The Veterans Administration, for example, recently launched a telehealth program for rural vets with PTSD. With more than 500 vets–all of whom had not yet received cognitive or prolonged exposure therapies previously–signed up for the study, indicating how telehealth technology may be the only option for many rural residents. 

Is telehealth a realistic solution? 

A primary concern among rural physicians is whether telehealth is a realistic solution for their practice-financially and technically. The good news is that federal programs and advancements in technology are helping to rectify disparities in care. 

In February 2018, the House and Senate passed a budget deal that included the Creating High-Quality Results and Outcomes Necessary to Improve Chronic Care Act of 2017 that allowed Medicare to cover more services for treating chronically ill patients. This was the largest boost to federal telehealth coverage in 17 years. The act has instigated legislators to funnel more Medicare money into telemedicine by allowing Medicare to cover more services for treating chronically ill patients. 

Technology has advanced to the point where implementation of a telehealth program can be simple and cost effective. Full integration of mobile apps, patient portals, and video capabilities-all within a cloud-based EHR-is no longer the future, but actually the easiest way for a physician to launch a HIPAA-compliant telehealth program.  

With tools such as telehealth, rural physicians can better coordinate care for medically complex patients and address the root causes of diseases. Telehealth becomes the equalizer between urban and rural areas, giving everyone access to high-quality care, regardless of where they reside.

Baha Zeidan is founder and CEO of Azalea Health, changing the way health IT platforms connect community-based healthcare providers and patients across the lifecycle of care.



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