Telemedicine is an essential part of the solution to America’s rural health crisis. It reduces travel and cost barriers while expanding the availability of basic and specialized care in areas with severe shortages of health providers. But the sad truth is that, too often, the communities that would benefit most from telemedicine sit on the wrong side of the digital divide. On Feb. 10, we’re joining forces on a Health Datapalooza panel that will discuss how health providers can come together with policymakers, payers, and internet service providers to ensure that rural communities have the opportunity to achieve health equity through high-speed internet access.
The Promise of Telemedicine
Living in a rural area is linked to serious negative health consequences. On average, Americans living in rural communities have a shorter life expectancy and are more frequently afflicted by preventable illness. They also face serious complications accessing health care – often traveling hours for a routine check-up or to reach a hospital when a health crisis strikes. Finally, people in rural communities encounter social barriers to care: they are more likely to live below the federal poverty level and less likely to have health insurance.
Since Atrium Health and Navicent Health partnered in 2019, we have worked to expand and improve health care services across the Southeast, especially in rural areas. Telemedicine has been the cornerstone of this effort. Our patients use wearable devices to remotely track heart conditions, video chat to speak with mental health providers, and use eVisits and virtual visit technology to quickly and effectively treat minor illnesses. Telemedicine has shown tremendous potential to overcome social barriers to care – no matter how far away a patient is from their doctor.
Atrium Health has seen particularly strong results with our Levine Children’s School-Based Virtual Clinic, which uses streaming video to provide in-school care to elementary school children living in rural areas with high rates of poverty and unemployment and a lack of insurance coverage and access to primary care. This first-of-its-kind pilot program delivers essential care while easing travel and financial burdens for both children and their parents. Through the virtual clinic, our pediatricians perform remote checkups, treat minor illnesses, and deliver behavioral health counseling to children who need it – all while using state-of-the-art equipment. Virtual stethoscopes are used to stream the sounds of the heart and lungs and capture real-time video of a student’s ear drums, and high-resolution cameras help our pediatricians evaluate a student's eyes, nose, throat, and skin.
In its first year, our School-Based Virtual Clinic cut emergency department visits in half and reduced illness-related school dismissals by more than one-third. Atrium Health has relied on various private funders to support this effort, including nearly $1 million in grant funding from Blue Cross and Blue Shield of North Carolina and Kohl’s Cares. Because government and private insurers often do not cover virtual visits, these kinds of investments are necessary to reap the long-term health benefits and cost-savings of innovative telemedicine programs such as ours.
A New Digital Divide
Most people know that a digital divide exists in America – between those who have internet access and who don’t. While it’s true that income is a decisive factor of where people fall on the digital divide, geography has also proven to be a strong predictor. Roughly one-third of rural residents in the U.S. do not have broadband internet in their homes, compared with 25 percent in urban areas and 21 percent in suburban areas.
Telemedicine programs can only work in communities that have fast, reliable access to broadband service. That’s why we’ve supported statewide legislation calling for rural broadband expansion and increased federal funds for rural broadband infrastructure (e.g., fiber optic cables, wireless mobile networks, and satellite broadband) through the farm bill. These measures are needed to give rural residents the tools to access high quality health care.
Many Voices, One Solution
As physicians, we have seen how telemedicine improves both the quality of health care and quality of life for Americans living in rural areas. A strong national broadband infrastructure would enable patients in rural communities to access online resources, providers, and services to better manage their health. Getting there, however, will require both invention and investment from multiple stakeholders:
- Health providers must pursue inventive virtual programs that deliver critical health services to rural patients in hard-to-reach communities.
- Insurers must provide parity in their coverage of telehealth services.
- Foundations must help fund innovative telehealth programs that are not currently reimbursed by traditional insurance providers.
- Elected officials must support budgets and legislation that expand the physical infrastructure that powers broadband service.
- Internet service providers must deliver quality broadband services to rural communities at affordable prices.
Many complex problems persist in modern medicine. But bridging the digital divide is relatively simple. The solutions that we will outline in our Health Datapalooza panel could transform the health prognosis of millions of Americans living in rural communities. We hope you’ll join us in this effort.
The opinions expressed in this blog post are the authors’ own and do not necessarily reflect the view of AcademyHealth.