Telehealth in Rural Areas: Successes and Complications


Welcome to this week’s healthcare Knowledge Knugget! As a part of “The Executive Innovation Show” podcast, we’re bringing you the hot topics, including answering questions that we receive each week, game-changing ideas, best telehealth practices, and tips. During today’s topic, Carrie Chitsey talks about the successes and complications of telehealth in rural areas.


Benefits of Telehealth in Rural Areas


COVID has shed much light on providing telehealth to demographics that generally weren't being served via telehealth before. This includes the Medicaid and Medicare populations and the rural demographics, who didn't have access to specialty medicine or emergency medicine without traveling long distances, like 30 or 40 miles for an appointment. Telehealth has decreased driving time for patients significantly living in rural areas. This has enabled more convenience for those patients' routine visits while providing better care access.


For example, chronic care patients can now access specialty medicine, like oncology and nephrology, through telehealth. Whereas, before telehealth adoption, there was a shortage of access to specialty medicine in rural demographic areas.


There are a lot of issues when it comes to receiving care for mental health in rural demographics. For instance, some rural cities with a million people only have access to one or two psychiatrists living within the community. So, when talking about providing rural health telehealth services such as telebehavioral health, there is a significant benefit. This is the same on the addiction and substance abuse sides too.


Barriers to Telehealth in Rural Areas


Regarding the complication side of telehealth in rural areas, there have been a lot of talks about bandwidth being an issue in these demographics. And indeed, that is a current issue and a concern on the telehealth side. Even though in rural demographics, the home internet is not as big of a wifi problem.


However, there is still significantly less high-speed internet when looking at carrier networks and cell phone towers within rural residences. In fact, with the increase in people working and taking online classes from home, the congestion in these rural cell phone towers has, unfortunately, hurt telehealth.


Telehealth is not only about how much bandwidth the provider and patient have, despite what the news may say. To have reliable telehealth sessions, both the clinician and patient need to have 1.5 to 2.0 megabytes to uphold both sides of the video call’s quality; this is because they have two video streams and two audio streams. And so to carry both of those sides, you need 1.5 to 2.0 megabytes. Then we start talking about the pixel and the resolution rate.


When it comes to camera quality, it is measured through high-definition or HD. HD starts at 720 pixels(p), and even then, that's still "semi-HD."


Standard HD is 1080p. When breaking down HD for rural demographics, if many people use the same home wifi or are on an LTE network through their cell phone's carrier tower, the screen resolution will go down dramatically. So, within rural demographics, people may see 320p, and in some cases, 180p. That will cause less usage of the bit rate, which measures how much data is transmitted in a given amount of time.


Then there are frame rates. Typically an excellent frame rate is 30. That's what a person will usually get on their television or DVR. And so when that gets reduced, too, it's all of these factors that affect rural healthcare demographics. Overall, One Touch is paving a significant way to expand access to telehealth programs within rural communities. There have been so many successes and so many "opened-up" billable codes that are really keeping patients safe, providing better access, and helping out caregivers taking care of their senior parents without and having to take off work and drive them to appointments.


Thus, the successes outweigh the complications. As a rural demographic provider, they must have patience because they will have patients who will drop off because of bandwidth, so providers might have to reconnect from time to time. But again, if this saves patients one to two hours from a five-minute, in-person face visit with their provider, it is worth implementing telehealth. So if you are a provider in that area, hang in there. The successes outweigh the complications, but it will take just a little bit more time.


Filled with insightful information, “The Driving Forces of Telehealth Adoption During COVID” infographic is now ready for download. Visit our resource center to the healthcare podcasts where we talk about all the use cases for telehealth. Subscribe to the podcast and rate us! Have a Knowledge Knugget idea? Reach out and submit today.



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