Approaches to Improve Remote Access to Healthcare

In rural areas, people may need to travel long distances to access healthcare services. In addition, many rural communities lack public transportation systems, and some rural residents may not have access to their own vehicle. Telehealth applications and mobile health clinics are two promising approaches to overcoming some of these challenges by delivering healthcare services to rural patients outside of a clinical setting.

Telehealth

In this model, telehealth applications are used to deliver healthcare services to rural patients remotely through different technology platforms. Telehealth uses telecommunication technology to deliver healthcare services and can include remote patient monitoring and mobile health communication. There is evidence that telemedicine programs can increase access to care, including specialty care for rural patients.

For more information about telehealth approaches and implementation of rural programs to address SDOH, see the Rural Telehealth Toolkit.

Mobile Health Clinics

Mobile health clinics are vans, buses, or small trucks that have been converted into small clinics that travel to areas where patients may have limited access to care. These mobile units can offer a variety of healthcare services, including immunizations, health screenings, and laboratory services. Mobile health clinics can address SDOH by connecting rural communities without regular access to healthcare providers with medical care. For example, there is some evidence that mobile clinics that offer reproductive health services can improve prenatal care and potentially reduce preterm births.

Transportation barriers continue to be one of the biggest challenges for rural residents accessing healthcare. The Rural Transportation Toolkit provides further examples of how mobile clinics are working to overcome barriers to care. Other promising approaches include:

• School and Workplace-based Healthcare
• Home Visiting Programs

For additional information about other rural programs that are working to overcome rural transportation barriers to address SDOH and improve healthcare access, see Transportation Models and Promising Rural Transportation Models in the Rural Transportation Toolkit.

Examples of Rural Programs Improving Remote Access to Healthcare

• The Garrett County Health Department in Maryland is addressing SDOH for residents with substance use disorders through a telehealth program. The program provides medication-assisted treatment for people with an opioid disorder and supports patients with counseling and medication adherence. The program uses telehealth technology to make buprenorphine available to patients who are receiving outpatient therapy and addresses transportation challenges.
• The Health Wagon is a mobile health clinic that increases access to free healthcare services in several rural Virginia communities. The Health Wagon provides many different health services to patients and also helps with care coordination and connecting people with additional support services. The majority of patients served by the mobile unit are uninsured.

Implementation Considerations

Programs looking to implement approaches to improve remote access to healthcare should consider the importance of funding strategies, the need for specific resources and staff, and technology infrastructure. A lack of broadband access continues to limit implementation of telehealth strategies in many rural areas. In addition, in some settings patients must still travel to a medical center to use the telehealth equipment for a visit.

For implementation considerations for implementing rural telehealth programs to address SDOH, see Implementation Strategies for Rural Community Telehealth Programs.

Resources to Learn More

Can Telehealth Help Address the Social Determinants of Health?
Audio
Podcast discussing how telehealth strategies can impact social determinants of health.
Author(s): DeSalvo, K.
Organization(s): American Telemedicine Association

Healthcare Access: Telehealth
Website
Publications and webinars that describe how telehealth and telemedicine approaches can address health disparities and increase access to healthcare. Provides information relevant to rural and underserved areas.
Organization(s): Association of State and Territorial Health Officials