As telehealth continues to gain in popularity, many have championed it as an answer to the rural health care provider shortage. However, one well-known challenge continually arises: telehealth requires Internet of some sort; more specifically, a high-speed connection. For more developed communities, Internet access isn’t particularly hard to come by. The same is not true, unfortunately, for many rural areas. According to a poll conducted by NPR, one in five Americans residing in rural communities still struggle to get access to high-speed Internet. Obviously, telehealth is a valuable tool for rural health care providers, but what good is another way to treat patients if they struggle to even access it in the first place?
For one woman, Jill Hill, profiled by NPR, the answer to this
question came a bit differently. She was in need of a therapist to help her process
the death of her husband, but the health center in her California community
could only offer her therapy once a month. Ms. Hill knew she needed more
frequent visits. Fortunately, under California Medicaid, she was eligible for a
service that permitted her to speak with a counselor via a computer, allowing
her to receive counseling more frequently. All she needed to do was drive to
her nearest health clinic. Though she was initially hesitant, the arrangement ultimately
worked very well for Ms. Hill, and gave her the support she needed in a way
that suited her current situation. While this may be a viable option for many patients
like Jill Hill, however, as NPR notes, “most rural health
facilities don’t include telehealth services, which means most patients living
in remote areas would need their own broadband Internet access at home to get
therapy online.” Thus, we are brought back to the original issue: what
good is telehealth if patients are unable to access it in the first place?
Attorney Mei Kwong, executive director of the Center for Connected Health Policy in Sacramento, finds the biggest barrier facing rural residents is the disparity in the technology available and the laws governing payment standards for using that technology. For example, as she told NPR, “high-resolution photos can now be taken—and sent anywhere digitally…[b]ut the policies on the books of what Medicare, Medicaid, and private insurers will pay for often means these services are not fully covered.” Hopefully, services and payments will standardize in a way that benefits patients while giving providers access to an additional tool through which to reach and treat patients.