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Telehealth Models Result in Positive Outcomes for Rural Populations


Rural populations have the opportunity to leverage telemedicine to improve health outcomes.

Telehealth models are associated with positive outcomes for both patients and healthcare professionals, especially in rural communities across the U.S.

Findings of a new study suggested such models were feasible and could be effective.

In rural populations, there are gaps in design and effectiveness of technology for treating diseases and addressing social determinants of health. So, Michael Butzner, Dr.P.H., and a colleague evaluated literature on current applications, therapeutic areas, and outcomes of telehealth interventions in such communities in the U.S.

To conduct the narrative review, the team searched PubMed MEDLINE from January 2017 to December 2020. They searched terms including “telehealth,” “telemedicine,” “rural,” and “outcomes.” Randomized controlled trials, mixed methods studies, qualitative studies, post hoc analyses, and prospective and retrospective cohort studies were included.

Overall, 15 studies reported telehealth intervention outcomes and were reviewed by the investigators. The areas examined were mental health (n=3), HIV (n=2), reproductive care/women’s health (n=3), osteoporosis (n=1), orthopedics (n=1), acute ischemic stroke (n=1), cancer (n=1), substance use disorder (n=1), ophthalmology (n=1), and emergency medicine (n=1). Study outcomes focused on feasibility and acceptability of telehealth, diagnostic and treatment validation of telehealth, patient satisfaction and self-confidence, education and training, and telehealth design features (prevalence and access, type of service, and therapeutic area).

Among the studies that analyzed telehealth interventions in patients, the findings demonstrated internet, electronic adherence monitors, and telelactation were feasible and accepted in rural, underserved populations, and improved access to care. Additional studies highlighted advantages of telemedicine visits, including decreased indirect and direct costs, lower travel costs and travel times, similar patient satisfaction compared to onsite visits, and patient satisfaction among telelactation users.

What’s more, healthcare providers and patients considered the technology convenient and efficient. Use of telehealth resulted in lower onset healthcare resource utilization, improved physician recruitment and retention, improved access to care, and increased education and training of patients and healthcare providers.

Still, several disadvantages to telehealth were reported. Disadvantages included having visits with unknown providers and technological issues like loss of connectivity and limited Wi-Fi access in rural areas.

“The findings support the existing literature on the need to increase and validate telehealth interventions and further update and implement policies to increase access and provide high-quality telehealth programs,” Butzner and his colleague concluded.

The study, “Telehealth Interventions and Outcomes Across Rural Communities in the United States: Narrative Review,” was published online in the Journal of Medical Internet Research.

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