By Dr. Kara Hartl

It’s no secret that America’s rural healthcare systems are in crisis: 136 rural hospitals closed their doors between 2010 and 2021, and 453 more are at risk of closing. While increased governmental support during the height COVID-19, temporarily helped turn the tide, in most ways, the pandemic exacerbated the healthcare-related issues these communities face.

Fortunately, for every storm cloud, there is a silver lining. While COVID-19 was a raging storm, the widespread expansion and embrace of telehealth that it prompted is an enduring silver lining. A McKinsey & Company study showed physicians now see between 50 and 175 times more patients via telehealth than they did prior to pandemic’s onset. Furthermore, the National Rural Health Association (NRHA) notes that a majority of healthcare providers believe technology – and the low-cost, highly effective solutions it can provide – has an important role to play in meeting the unique obstacles to the much-needed care that rural communities face.

Patients in rural communities often struggle to access healthcare, for reasons including limited transportation options, a shortage of healthcare providers, and a lack of specialized services. Top-notch telehealth care can help to bridge these gaps by enabling patients to receive care remotely, without requiring healthcare providers to travel to rural areas.

Successfully delivering high-quality healthcare via telehealth is not without its challenges; but when care providers follow five best practices, the outsized benefits to this mode of healthcare delivery are clear.

Leverage telehealth to increase access to care
Nearly 1 in 5 Americans reside in rural areas, yet only around 12% of doctors practice in these communities. Rural America is especially low on specialists: Rural areas have about a third as many specialists per capita as urban locales. A growing shortage of doctors in the US will likely result in even fewer on-site physicians in rural communities, and limit patients’ access to care even further.

Many healthcare providers are reluctant to live in rural areas, and travel can be time-consuming and costly. Telehealth technology allows healthcare providers to expand their reach and provide care to patients living in rural communities without the need for those physicians to travel to or reside in remote locales. By utilizing telehealth, specialists can deliver quality care to patients from any location, ensuring that patients in rural communities receive the care they need, regardless of their location.

Help providers and patients use the technology effectively
Rural patients tend to be older and have more health problems than their urban counterparts – all reasons why this population, in particular, can benefit from telehealth services. Unfortunately, persuading older patients to use virtual healthcare platforms remains a challenge. According to Pew Research Center, 27% of U.S. adults aged 65+ reported they did not use the internet in 2019. Even among those who are online, lack of comfort using telehealth technology can be an obstacle.

Telehealth providers must be able and willing to provide training and support to patients, making sure that they feel comfortable using telehealth technology and can access care without difficulty. Thus, healthcare providers themselves must be proficient in the technology. They should be able to coach patients in how to get online, login, navigate the system and otherwise avoid potential technological issues that may affect care delivery.

Assist patients with navigating the medical insurance system
The US medical insurance system is complex, and the average average patient has no idea how to navigate it. This is particularly true when it comes to getting authorization for telehealth services – particularly specialized care – and understanding insurance coverage for this type of care.

Healthcare providers must, therefore, help patients navigate the medical insurance system, including authorizations, medical billing, and other financial concerns. By providing this guidance, providers can ensure that patients receive the care they need without undue stress or confusion.

Facilitate local support for disease management
While telehealth is an important tool, complex disease management usually requires local support. Patients need a community contact who can help them with local healthcare resources for things like labs and imaging, and who can otherwise answer the question, “What do I do next?”

For this reason, a hybrid telehealth model is the gold standard. This model calls for coordination of three key elements: a small medical clinic in the local community with a dedicated medical assistant physically present to help patients; an administrative staff to manage the logistics of the healthcare system; and a team of specialists delivering expert medical care via telehealth.

Prioritize personalized care
Medicine is so much more than a doctor on a screen telling a patient what's wrong and what to do. Effective telehealth medicine is rooted in strong physician-patient relationships. A study from the Bipartisan Policy Center and the Center for Outcomes Research and Education found that many rural patients were reluctant to use telemedicine, even when it was readily available. Their primary worry was the quality of the care they would receive.

This concern highlights the importance of telehealth providers creating strong relational ties with their patients, especially when providing care remotely. The trust and understanding that grows when care is personalized is key for good outcomes, particularly in complex cases. Here, too, the value of a model that comprises both online and in-person care becomes clear.

By adhering to these best practices, healthcare providers and telehealth platforms can ensure that patients in rural communities receive the care they need to thrive.

About the author: Dr. Kara Hartl is the founder & CEO of Troy Medical, a telemedicine company bringing medical specialists to remote and medically underserved communities.