Health care in rural America is hurting. Medical facilities are closing and doctors, nurses, physician assistants and other health professionals are in short supply.
At least 100 rural hospitals have closed since 2010 and more than 400 are at risk of financial distress. Meanwhile, physicians between the ages of 55 and 64 make up 27% of the active workforce. As the demand for health care services rises over the next decade, there will not be enough providers to fill the gap left by those retiring. The American Association of Medical Colleges projects a shortfall of between 42,000 and 121,000 physicians by 2030.
Telehealth--the use of electronic information and telecommunications technologies to support long-distance health care--has the potential to address both of these challenges.
Telehealth gives rural patients access to more providers and allows them to receive care in their home communities, instead of traveling sometimes long distances. This can reduce health disparities for aging and underserved populations, as well as lower the costs and burdens for patients who must take time off work and find child care or transportation. Patients can instead stay at home or visit a nearby clinic and have a live video visit with primary care providers for treatment of acute or chronic issues.
Many policymakers, particularly those from states with large rural areas, see telehealth as a key component in the future of health care in their state. But along with the benefits come potential challenges, including a lack of access to broadband, state licensure issues, questions about the quality of telehealth, and the need for in-person follow-up care for patients with certain conditions. Despite these potential difficulties, most states are increasing their investment in telehealth services.
North Dakota uses telehealth because the state lacks providers in its rural counties. According to Representative Judy Lee (R), 36 of the state's 53 counties are designated "frontier" counties, with six or fewer people per square mile. "Telehealth is one of the tools the state uses to provide follow-up care, particularly in the behavioral health field," she says.
State legislatures are designing regulations and laws on telehealth to increase patients'access while ensuring their safety. Strategies include licensure compacts and reciprocity agreements, expanded reimbursement, store-and-forward technology, and new rules on patient-provider relationships.