“There is no future of rural healthcare without telehealth.”

That was the message articulated by Alan Morgan, CEO of the National Rural Health Association. The prediction is made more grave by the consistent challenges rural providers are facing when it comes to telehealth utilization.

In 2020, 34 percent of rural Medicare beneficiaries were telehealth users, compared to nearly half of beneficiaries in non-rural zip codes, according to University of Michigan research. Many rural patients viewed much of this early pandemic telehealth use as a temporary replacement for in-person care, so rural usage rates are dropping more as the country moves further from its lockdown days. 

During a Tuesday panel discussion at HHS’ National Telehealth Conference, Morgan called the fact that rural providers’ telehealth use lags far behind that of urban providers “beyond frustrating.” His organization has found that as rural providers implement telehealth services, many are struggling to address key questions about the patients they serve: Do they have broadband access? Do they know telehealth services are available to them? Do they know how to use the technology needed to virtually connect to their caregiver?

While these questions remain thorny and represent issues that need to be addressed, there is no doubt on one thing: Healthcare doesn’t need any more data showing how telehealth improves care delivery and patient satisfaction, Morgan declared. He thinks the industry should instead focus more of its research on identifying which barriers are preventing telehealth from entering rural patients’ homes.

One of these barriers is undoubtedly connectivity. In fact, the absence or spottiness of broadband access is a key obstacle contributing to the disparity between rural and urban telehealth utilization. Fellow panelist Rene Quashie, the Consumer Technology Association’s first ever vice president of digital health, pointed out that many healthcare leaders now consider broadband access a social determinant of health. While the data is clear that telehealth has significant potential to reduce costs and improve health outcomes among rural populations, these results will not be achieved if patients cannot access virtual care.

In addition to their struggles in addressing the digital divide, many rural health providers are not adequately marketing their telehealth offerings. Morgan said there are “some wonderful communication tools going out to urban patients that I’m not seeing for rural patients.”

He and fellow panelist Ann Mond Johnson, CEO of the American Telemedicine Association, said communication about telehealth can be improved through partnerships with local organizations and community leaders, as patients are more likely to trust these messengers and heed their messages.

This need for programs designed to scale rural patients’ telehealth use is especially dire as healthcare’s workforce crisis intensifies. 

“If you’re engaged in rural healthcare, you are well and acutely aware that the pandemic has simply crushed the rule workforce,” Morgan said. “It has completely crushed it.”

The NRHA says the patient-to-primary care physician ratio in rural communities is 39.8 physicians per 100,000 people, compared to 53.3 physicians per 100,000 in urban communities, a disparity that is exacerbated by the country’s ongoing shortage of healthcare workers. 

Operating with the knowledge that rural communities will not be able to train enough clinicians to adequately provide for their populations, Morgan said rural providers must turn to telehealth to ensure patients’ access to care.

“It’s a sad state of affairs that the current workforce situation has left us no other opportunity, but for the federal government and private payers to really push for an adoption and utilization of telehealth going ahead, Morgan said. “There really is no other option.”

Photo: Maria Symchych-Navrotska, Getty Images