Telehealth Use in Rural Healthcare – Models and Innovations
These stories feature model programs and successful rural projects that can serve
as a source of ideas and provide lessons others have learned. Some of the projects
or programs may no longer be active. Read about the
criteria and evidence-base for programs included.
Need: To provide evidence-based psychotherapy for depression in elderly veterans who are unable to seek mental health treatment due to distance or stigma.
Intervention: Telepsychology-Service Delivery for Depressed Elderly Veterans compared providing behavioral activation therapy via home-based telehealth and the same treatment delivered in a traditional office-based format.
Results: A 2015 study and two 2016 studies show that providing treatment via home-based telehealth to elderly veterans in South Carolina resulted in the same improved health outcomes, quality of life, satisfaction with care, and cost of healthcare compared to those receiving face-to-face treatment.
Need: Arkansas had high rates of low birthweight babies, and pregnant individuals in rural areas had difficulty accessing specialty obstetric care.
Intervention: The University of Arkansas for Medical Sciences (UAMS) created the Institute for Digital Health & Innovation (IDHI) High-Risk Pregnancy Program to increase access to care for pregnant individuals in an effort to improve outcomes for high-risk pregnancies.
Results: The program has increased access to care and improved neonatal outcomes for rural Arkansas individuals through a variety of programs and has been recognized by various organizations as a model program.
Need: To enhance palliative care access to rural patients with advanced cancer or heart failure and their family caregivers.
Intervention: Project ENABLE consists of: 1) an initial in-person palliative care consultation with a specialty-trained provider and 2) a semi-structured series of weekly, phone-delivered, nurse-led coaching sessions designed to help patients and their caregivers enhance their problem-solving, symptom management, and coping skills.
Results: Patients and caregivers report higher quality of life and lower rates of depression and (caregiver) burden.
Need: To increase the capacity for more effective treatment of chronic, complex conditions in rural and underserved communities.
Intervention: Through a specially-designed project, remote primary care providers work with academic specialists as a team to manage chronic conditions of rural patients, expanding remote providers' knowledge base through shared case studies.
Results: Patient management and care provided by rural providers through ongoing education and mentoring from Project ECHO® has proved as effective as treatment provided by specialists at a university medical center.
Need: To increase access to telemental health services for rural veterans, especially women, with a history of trauma.
Intervention: STAIR (Skills Training in Affective and Interpersonal Regulation) is a 10-week program designed to reduce PTSD and depression symptoms and increase emotional regulation and social functioning in clients.
Results: Therapists reported that clients attended more sessions when offered via teleconferencing, and clients reported satisfaction with the program.
Need: Many physicians want to help rural children who are overweight or obese develop healthy lifestyles, and these physicians would benefit from receiving training on specific ways to instruct, motivate, and manage the healthcare of these children.
Intervention: A virtual learning network called Healthy Eating Active Living TeleHealth Community of Practice (HEALTH-COP) was created to educate rural physicians and provide peer support.
Results: Studies showed an increase in health and wellness topics covered by physicians during children's clinic visits. This likely contributed to healthier eating habits and more active lifestyles that were found when these children were reassessed 3 months later.