Improving primary care in rural areas with telemedicine


Health professional shortage has remained a pressing problem throughout the US since 2020. However, rural areas are disproportionately affected: according to Statista, 65.5% of medical staff shortages in the primary care field are in rural areas, compared to 29.5% in urban and suburban ones. Despite joint efforts of healthcare organizations, software vendors, and the government to close this gap with the help of telemedicine solutions for primary care, rural patients remain medically underserved. The recent research conducted among the rural and urban Veterans Affairs beneficiaries showed the significant divide in telehealth usage.

Thus, to compensate for the medical staff deficit with telemedicine, we should consider the nuances of this technology’s implementation and usage, as applying the same adoption principles for rural and urban regions is counterproductive.

Telemedicine implementation and usage challenges in rural areas

Technical challenges

Internet bandwidth was listed as the number one barrier in telemedicine usage by rural patients. There are numerous factors contributing to low speed in many households: the necessity to attend school and work online for many people overburden the bandwidth of the rural Internet, which is already insufficient because of the rapidly aging infrastructure. At the same time, connectivity providers who strive to improve their services are rising prices, and new tariffs are often too high for the rural population. At the same time, video visits are among the most reimbursed and effective types of telecare. Consequently, healthcare providers prefer to hold video sessions while many people don’t have the means to attend them.

Demographically determined challenges

The US Census Bureau found that the percentage of residents aged 65 and older is disproportionately higher in rural regions. Though smartphone and tablet usage has spread significantly among older people in the past ten years, their digital literacy still remains low.

That means patients who require doctors’ attention most often are the ones who don’t have the skills to use telehealth technology. Additionally, many rural regions include a larger proportion of low-income households that can’t afford smartphones and tablets with capabilities that support quality video conferencing.

Possible ways to increase the adoption and usage rates of telehealth in rural areas

Many of the above-mentioned issues can’t be solved without changing the rural infrastructure and overall quality of life for rural populations. There are, however, a couple of actions that healthcare organizations can take right now to improve the situation.

  • Broadening the variability of patient communication and engagement channels

Active usage of audio consultations over the phone or live messaging can help those patients who can’t communicate via video calls. Despite video format being the most effective type of telehealth services, healthcare providers should have fall-back options for situations when video fails.

For example, older patients can choose phone calls as  a preferred form of communication.  Patients or their caregivers can also fill out some medical forms  and send them to physicians to help assess patients’ condition better while cutting down the amount of videoconferencing time.

  • Establishing a point of care

Public libraries and coworking spaces have become the hub for people who don’t have sufficient Internet access to work and study online. The same principle can be used to help people access virtual care. Setting up a point of care in the public facility with satisfactory connectivity and a trained medical practitioner who can assist patients with reaching their more experienced colleagues via telehealth would mitigate the problem of individual access to telehealth.

Patients with low Internet speed who require more in-depth care than what is possible to achieve via phone or text conversations still wouldn’t have to travel far to see the doctor. At the same time, personnel in such centers wouldn’t have to be fully trained primary physicians, as their required skills would be the ability to connect a patient to a licensed professional via the telehealth solution.

  • Providing more thorough education to patients and caretakers

Healthcare solution providers and medical professionals develop strategies to better inform rural patients about the telehealth options they have. Many patients might have no idea that it isn’t always necessary to attend a video consultation, and they have other means of contacting their primary care provider.

Additionally, step-by-step instructions on how to properly set up and use each channel of communication must be available. Naturally, a support team should handle all technical questions from patients so the healthcare professionals don’t have to.

  • Understanding a particular rural community and addressing issues

Each community has its own reasons for low telehealth adoption.  It is crucial for telehealth service providers to know their audience and build strategies to address the current challenges. Employing analytical solutions would be the best tactic. It allows healthcare and connectivity providers to gather data on the quality of Internet connection, as well as age and conditions of the patients, their income, and technological literacy in each rural region. Then they process this data and draw insights, which can be used to address the needs and limitations of each community.

In conclusion

Rural regions falling behind on telehealth adoption and usage is a systematic problem that requires action from multiple government and non-profit organizations, connectivity providers, software vendors, and other entities.

Updating telecommunication infrastructure, encouraging healthcare providers to take on more remote consultations, and fighting poverty in rural areas is essential to closing the gap between rural and urban communities’ telehealth usage.

For now telehealth software providers and medical professionals can improve the situation by clearly understanding the rural patients’ needs and establishing more appropriate workflows for a particular patient group.