Limited Resources Led to Lower Telehealth Engagement Among Rural Residents

New research shows a difference of 25.1 percentage points in the increase in telehealth engagement among rural and urban residents during the pandemic, indicating the need for additional resources.

Research published in the American Journal of Preventative Medicine (AJPM) found that rural residents had lower telehealth engagement rates during the COVID-19 pandemic than their urban counterparts, showing the need for geographic targeting and the provision of additional resources.

Although telehealth provided many patient benefits during the COVID-19 pandemic, research on which demographics benefitted the most is ongoing. This study aimed to determine whether the location of residence had an influence on care quality by comparing data on rural and urban residents from before and during the pandemic.

The study included data for more than 1 million patients who received care through 446 separate safety-net clinics. Of these clinics, 83 percent were urban clinics, 10.3 percent were large rural clinics, 4.1 percent were small rural clinics, and 2.6 percent were isolated rural clinics.

Researchers noted that prior to the COVID-19 pandemic, there was no noticeable correlation between the type of visit —in-person or virtual — and residence. However, during the pandemic, telehealth visits increased by 27.2 percent among those living in isolated rural areas and by 52.3 percentage points among those living in urban areas.

Although there was an overall increase in telehealth use in all types of residences, telehealth visits were consistently lower among rural patients than among more urban patients.

Researchers noted that the future of telehealth equity will be influenced by reimbursement. However, this does not diminish the clear need for additional resources and attention dedicated to patients living in rural areas, particularly those who are isolated.

However, one limitation of the study is the use of patient addresses to determine living locations, which were gathered solely from patient EHRs.

Following similar conclusions in studies that noted a lack of virtual care resources in rural environments, various efforts have aimed to expand access for these patients.

Last week, Equum Medical announced that it is working with the National Rural Health Association (NRHA) to add telehealth tools to treatment practices to improve access within rural communities.

Several Equum services will be shared with NRHA members, including tele-ED, which supports surge and early intervention, and tele-critical care, which supports models of intensivist-led care.

Similarly, a hybrid care provider that specializes in rural healthcare called Homeward partnered with Priority Health in August. New as of early 2022, Homeward centers its efforts around rural healthcare interventions. This collaboration will allow the organization to provide its suite of virtual and in-person services to Priority Health plan members within 14 different Michigan counties.