The word "pivot" or "shift" doesn't quite get across just how quickly healthcare was able to implement telehealth solutions after observing the shocking effects of COVID-19 on how care was administered. Several facilities truly stepped up to the plate and quickly adopted new strategies or adapted existing ones to better fit a remote care model. Of course, this wasn't a simple or even inexpensive transformation. Staff needed to be quickly retrained, medical computer systems needed to be repurposed for telehealth services, and patients needed to be weaned onto this new means of care. Fortunately, established facilities were able to answer the call.
And What About Rural Telehealth?
"Established facilities" is the key phrase in that success story mentioned above. While these larger hospitals being able to transform in this way has been very consoling during these trying times, smaller facilities that don't have access to the same resources have been struggling to keep up. It also doesn't help that rural hospitals often run on very tight budgets, typically surviving on money brought in from non-essential treatments which have either been restricted or put on hold. Pair all that with the fact that they serve a population that is inherently at higher risk of contracting not only COVID, but several other illnesses, and it's no surprise why 21% of the nation's rural hospitals are at high risk of closing based on their total operating margins.
All that said, hospitals still have a responsibility to provide rural telehealth however they can to the patients in their communities. Below, we discuss the potential roadblocks to doing so and how they can be avoided.
What are the Barriers to Telehealth in Rural Areas?
In addition to the more general issues plaguing rural healthcare, there are 2 rural telehealth specific issues that need to be addressed before real investment in remote care can begin.
1.) Broadband
Loosely defined, broadband is telecommunication connections and services that allow users to exchange data at adequate volumes and speeds. "Adequate", of course, can vary based on the industry and the services being delivered.
According to the Federal Communications Commission, the benchmark for telecommunication (telehealth) services is a download speed of 25 mbps and an upload speed of 3 Mbps.Without these benchmarks, it's very likely your facility won't have the broadband necessary to achieve telehealth in any sort of meaningful application. Fortunately, a 2019 report on tribal broadband by the Congressional Research Service shows that even as far back as 2017, 75.7% of rural inhabitants had access to broadband that met the benchmarks for telecommunication.
If you're concerned your community may not meet the broadband requirements, you can always search your area on the FCC's map of areas that are confirmed to have 25/3 (Mbps) broadband access in order to confirm.
2.) Reimbursement
The issue of reimbursement for telehealth services has been a long-lasting one- well before the current pandemic convinced everyone of telehealth's merits. Rural patient populations, as mentioned in the study cited earlier, experience higher rates of unemployment, financial instability, and lack of insurance. This often translates to several instances of delivered care being either under-compensated or not compensated at all.
For those looking to begin a rural telehealth program that are concerned about compensation rates, it could help to brush up on what services are covered by Medicare's regulations. Keep in mind when looking these services up that this list might change, more may be added to the list of approved services in response to the global pandemic.
With both of those roadblocks in mind, you can progress with a rural telehealth program a little more informed about possible hiccups you could experience. As far as best practices go when actually ideating this program, consider these suggestions.
Take Advantage of Telehealth Resource Centers
Healthcare WANTS to embrace telehealth across the board and that means it also wants telehealth in rural areas to be accessible. It's only natural that resources exist to help rural communities that are disproportionately affected by disease uptake mobile care.
Telehealth Resource Centers exist and are federally funded to offer aid to providers who are interested in improving their telehealth efforts or even starting. These centers can provide information specific to your region or community and even make recommendations for vendors of telehealth software platforms. They also offer webinars geared towards informing providers on how to start implementing a telehealth program.
Building on our last point on reimbursement, these centers can even highlight what telehealth services your facility can be properly reimbursed for, making telehealth adoption less of a financial risk.
Repurpose Workstations to Better Support Rural Telehealth
Once you've confirmed that your community's broadband and available software providers can support a telehealth program within your facility, it's up to you to ensure your hardware and staff are also up to the task.
Portable workstation solutions can be incredibly helpful for allowing nurses and staff to move their computers into separate rooms where they can have secluded, private communications with their patients. Something like a VESA mount tablet that can be mounted onto a cart or even just carried by hand are lightweight, easy to use, and effective for secluded televisits.
If a tablet seems too low-power, you can even deploy medical cart computers with battery power functionality to receive that same benefit of portability. Not only do these solutions provide consistent, reliable power without needing to be tethered to an outlet (which opens up more space for a telehealth appointment), they also eliminate the need for bulky battery-powered computer carts, making the solutions themselves that much more portable.
If you're also running remote patient monitoring programs, you'll want to ensure that whatever workstation you invest in can support any of the peripherals you use to track patient vitals and symptoms effectively.
Only Provide Rural Telehealth Where You Feasibly Can
Implementing telehealth isn't an all or nothing approach. Firstly, it's likely most rural hospitals don't have the funding to provide every remote service possible anyway. More importantly, it's also not confirmed that once this medical emergency has ended that telehealth will stay the same as it is now. Many remote care options have only been embraced tentatively as a necessity of the times. While it's likely some of it will stay since it's been proven effective, not all of the approved telehealth services are likely to remain as we return to normal. The last thing you want to do is invest all you can in several telehealth services and then find out reimbursement/Medicare support for a few of those services ends once the pandemic has been squared away.
Instead, invest in evergreen telehealth solutions- ones you can likely see yourself continuing after all is said and done. For example, workstations like the ones we mentioned above can still help tele-triage patients, promote remote communication between staff and patient, and also provide after-visit consultations. It's likely these services are going nowhere even after the pandemic after we've seen how well they work.
Investing smartly where you can with telehealth in rural areas can impact you the least financially, bring in more business and revenue during these hard times, and even go on to deliver more returns on investment once these services stick around post-pandemic.
Meet Your Community's Needs Specifically
Telehealth in rural areas is harder to implement than more urban programs, but just as necessary. Fortunately, the resources exist to help these often underserved communities receive the care they need when and where they need it.
Starting to meet these needs of your community now can stand to benefit you both in the present and in the future as telehealth (and rural telehealth) continues to prove its worth in the coming years. For more information on the kind hardware needed to get started with rural telehealth, contact an expert from Cybernet today.