The people of rural areas face some serious health issues than those who live in towns and cities. Access to proper healthcare is a major issue in the rural areas in most of the countries. They might not be able to go to a hospital in times of emergency and in order to get routine checkups and screenings done, long distance travel is required. The people of the rural areas also experience poor health and have higher rates of chronic disease and mortality. With the wish to expand access and improve the quality of rural healthcare, telemedicine has come to life. Telemedicine seeks to reduce various burdens of patients of rural areas. With the use of telemedicine, one will not be required to travel to receive specialty care and thereby improve communication, timeliness and monitoring within the healthcare system.
According to definition by the Health Resources & Services Administration, telemedicine is comprised of the use of electronic information and telecommunication technologies that supports and promotes long-distance clinical healthcare, health-related education, public health and administration. Telemedicine can be done in various forms such as
- Remote patient monitoring
- Mobile health communication
There is no doubt about the fact that the rural hospitals are in grave trouble. Almost 48 rural hospitals have closed ever since 2010 and as per the reports of National Health Association, more 283 hospitals are in danger. Various factor effects the rural healthcare such as reduced healthcare, the absence of specialty services, underused equipment, a large number of elderly and uninsured patients. The unwillingness of doctors to work in remote areas creates issues in the quality of care and staffing. There is also a major challenge in getting patients to the hospital in time since the travel distance becomes too great. It is believed that telemedicine offers a way for such struggling rural hospitals.
According to the report ‘The Role of Telehealth in an Evolving Health Care Environment’, it is seen that telemedicine helps in accentuating the volume and quality of care. It also helps in reducing the costs by way of reducing readmissions and unnecessary department visits for rural communities. With the application of telemedicine, rural hospitals will be able to serve rural patients at a better cost and help in cutting down on the time required to deliver care particularly specialty care. Rural patients are aware of the use of telemedicine by the hospitals in rural areas, they will not be eager to seek out for the care of the urban facility.
Benefits:
There are a number of ways in which rural hospital are able to take advantage of telemedicine and such includes remote consultations, outsourced diagnostic analysis, monitoring at home along with specialist consultations. Instead of having to wait for a number of days or weeks for any healthcare professional to travel to a remote area, telemedicine will help in faster and cheaper method of remote consultations than traditional healthcare appointments. Much faster and cheaper services can also be availed instead of traveling to a hospital and waiting for an appointment. Remote consultations will also help the economics of rural hospital and improve the experience of the patients in cases of simple health concerns or on the follow up of existing conditions.
The second way in which rural hospitals are benefitting from telemedicine is through in-home monitoring. Patients who were previously diagnosed with heart failure, COPD, diabetes or those who experienced frequent hospitalization in the past can be monitored with telemedicine at home.
One another benefit to the struggling rural hospitals is the access to remote specialists and outsourced diagnostic analysis. It is not possible for many rural communities to staff their own diagnosticians. Therefore, to build this gap, mobile imaging centres and lab specimen kiosks can take X-rays and perform collections and then work in conjunction with remote analysis labs of the urban areas. One of the studies including 24 hospitals in the rural state including Kansas and Texas, showed that telemedicine brought an annual impact of $20000 per year with an impact of up to $1300000 on the whole (source: National Health Association). The main part of this savings came from pharmacy revenues due to the additional work that was performed within a locality.
Telemedicine will help in linking urban behavioural health and mental health to the rural residents. The network in Texas offers counselling services both by video and by phone. Interpreter services will also be provided through audio or video for patients with little or less knowledge of English.
Challenges:
Even though it is clear that remote consultation by video conferencing is beneficial but such remote consultations will amount to nothing if there is an absence of proper broadband infrastructure to support it. It is a known fact that rural communities are not only lacking population and resources, they are also facing trouble with the absence of required broadband infrastructure for telemedicine. The biggest problem is the ability of healthcare professionals to connect to those in the area with a limited wireless connection.
The method of reimbursement is another major challenge. With the states having their own way of reimbursing the Medicare programs, Medicare reimbursement is a major challenge. There is also the absence of a single method of reimbursement even for the private players. Some insurance companies’ do value telemedicine and so they will reimburse for a number of services while other companies might not.
Such challenges continue to burden rural telemedicine even when the demand for it is growing. There is even a possibility for the rural hospitals to move towards recovery even though obstacles remain.
There are a number of telemedicine funding programs that funds rural telemedicine projects. Some of which are:
USDA Distance Learning and Telemedicine Loan and Grant Program (DLT): This program provides financial assistance to improve the telemedicine services along with distance learning services of the rural areas.
USDA Community Facilities Loan and Grant Program (DLT): This program seeks to provide fund so that essential community facilities can be constructed or funded for healthcare in rural areas. The community facilities include schools, libraries, medical clinics, police stations and transportation.
USAC Rural Health Care Telecommunications Program: Such a project helps rural healthcare providers by giving discounts so that they can obtain internet and telecommunication services.
According to a report by the RUPRI Center for Rural Health Policy Analysis, both rural and urban hospitals had similar rates of telemedicine implementation. Rural hospitals are more willing to use telemedicine in many departments. There has been a substantial increase in the adoption of telemedicine technology in the US from 54.5% to 61.3% or 3.5%increase per year since 2014, thereby suggesting continued growth in rural areas.
PatientMD is a application based healthcare platform which provides a broad range of healthcare services, telemedicine being one of them. It aims to bridge the gap between patients and doctors and eliminating the time, distance and money issues. To know more about our telemedicine feature, watch the video.