The country’s rural communities make up two-thirds of areas suffering from a shortage of primary care physicians. At a conference hosted by the Department of Health and Human Services in May, Alan Morgan, CEO of the National Rural Health Association, said virtual care is the most meaningful way to address this care gap, declaring that “there is no future of rural healthcare without telehealth.”

This message appears to be heeded elsewhere. Carilion Clinic, a health system based in Roanoke, Virginia that has a sizable rural patient population, announced a partnership with TytoCare, a New York City-based telehealth company. The partnership aims to strengthen the health system’s ability to diagnose and treat patients remotely with virtual physical exams using TytoCare smart devices, such as its telehealth exam kits and pop-up remote health clinic.

Carilion provides care for nearly a million Virginians, many of whom live in rural communities. The health system first began exploring the use of telehealth to treat rural populations in 2016 when it received its first grant from the U.S. Department of Agriculture. The funding allowed Carilion to deploy behavioral health telehealth services in 12 rural counties in southwest Virginia, focusing mainly on patients with opioid use disorder.

After rolling out the behavioral health telehealth program, Carilion looked for other telehealth use cases. Dr. Steve Morgan, the health system’s senior vice president and chief medical information officer, said he read case studies about how other health systems were using TytoCare’s technology and quickly became interested in the company’s ability to help extend more telehealth services to rural patients. 

Carilion started exploring a partnership with TytoCare in 2019, looking at how performing virtual exams on rural patients could help reduce readmissions to skilled nursing facilities. The partnership was briefly halted during the onslaught of the pandemic, but the health system revived the effort in 2020 after receiving grants from the Federal Communications Commission and USDA to expand its use of telehealth devices.

Last week’s partnership announcement formalized a relationship that had been in the works for a few years, according to Dr. Morgan. He said Carilion chose TytoCare over its competitors, such as MeMD and Teladoc, for a couple of key reasons.

The foremost was the quality of TytoCare’s technology. When Carilion’s clinicians examined the technology, they found it could perform quality physical exams remotely on patients’ hearts, lungs, noses and throats. TytoCare allowed for the addition of various peripheral views and Bluetooth scales in one platform. Another reason was TytoCare’s ability to seamlessly integrate with Carilion’s overall  health technology architecture, including its Amwell telehealth platform and Epic EMR.

Additionally, TytoCare had demonstrated its abilities to operate within low bandwidth areas. This was an important piece of criteria for Carilion, as many of its rural patients have much slower internet connections. 

In its formal partnership announcement, Carilion said it is using TytoCare’s telehealth devices to monitor pediatric asthma patients remotely and care for rural patients with chronic conditions. The health system also will deploy the TytoClinic solution, which can turn any location into a remote telehealth clinic, in rural schools to increase students’ and teachers’ access to primary and specialty care.

Carilion’s main goal for this partnership is to strengthen its rural patients’ access to care by providing more care in their homes. Dr. Morgan said the health system will measure the success of this partnership by tracking metrics such as the frequency in which rural patients receive telehealth care, reductions in emergency department visits, and decreased readmission rates for hospitals and skilled nursing facilities. 

Dr. Morgan said the advancement of telehealth care is something all health systems that serve rural patients should champion, even though virtual care’s permanent coverage status remains undetermined by the Centers for Medicare & Medicaid Services.

“I think all hospitals are looking at where the federal government is going with telehealth reimbursement, but I still think it’s a value play for most healthcare systems,” he said. “The longer this technology is around, it will become less expensive. And it will reduce readmissions, reduce length of stay and potentially reduce emergency department visits.”

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