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Telehealth

Telehealth is a valuable tool to connect people to a health care provider when there are barriers to accessing transportation or it is not feasible to travel. This model uses telecommunications technology like video conferencing and smartphones to enable providers to deliver care to their patients from a distance. Telehealth can be used to deliver mental health treatment services, consult with specialists, provide obstetric care, and support chronic disease management, among a variety of other uses. Care can also be delivered in a community setting, like a rural primary care clinic, or it can take place in the patient’s home through remote monitoring systems.

Examples of Rural Programs that use Telehealth

An extensive list of evidence-based and promising telehealth models can be found in the Rural Health Information Hub's Telehealth Use in Rural Healthcare Models and Innovations and in the Technology and Telehealth Model of the Rural Services Integration Toolkit.

Considerations for Implementation

Reliable broadband infrastructure is a critical component of a successful telehealth network because it ensures that providers can consistently connect to patients. Broadband internet connections have download speeds of at least 25 megabits per second (Mbps) and upload speeds of 3 Mbps. According to the Federal Communications Commission, 39% of rural Americans (approximately 23 million people) do not have internet access that meets this standard.

Medicaid and private insurer reimbursement policies for telemedicine encounters differ by state, and may include restrictions on the type of service or type of provider who can be reimbursed. Providers seeking reimbursement through Medicare may have a different set of considerations. The Center for Telehealth and e-Health Law has additional information about telehealth reimbursement policies.

In some cases, healthcare providers who will be administering telehealth services, including prescribing medications across state lines, will need to be licensed to practice in the state where the patient in located. State-specific policies can be found at the American Telemedicine Association's State Telemedicine Policy Center. In addition, healthcare providers may be able to obtain assistance with obtaining licensure through national professional organizations like the American Medical Association or the National Council of States Boards of Nursing.

Special accommodations may be necessary at both the provider site and the patient site in order to facilitate effective and comfortable encounters. This may include modifications to address privacy concerns or make space for telehealth conferencing equipment.

Program Clearinghouse Examples

Resources to Learn More

Anticipating Economic Returns of Rural Telehealth
Document
This report describes the economic benefits to rural pharmacies, hospitals, communities, and patients who have access to telehealth services through broadband internet connections, including state-level estimates of savings. It may be useful for program planners interested in building support for investments in broadband infrastructure.
Author(s): Schadelbauer, R.
Organization(s): NTCA – The Rural Broadband Association
Date: 3/2017

Telehealth Resource Centers
Website
Telehealth Resource Centers are federally funded consortia that provide technical assistance and training to support the development of telehealth networks. Topics include reimbursement from insurers including Medicaid and Medicare, legal and regulatory concerns, and marketing.
Organization(s): Federal Office of Rural Health Policy, Office for the Advancement of Telehealth

Telehealth Resources
Website
A collection of fact sheets including information about policy barriers, reimbursement, funding, and choosing a telehealth vendor.
Organization(s): National Organization of State Offices of Rural Health