image: Neeraj Puro, Ph.D., co-author and an assistant professor, management programs/health administration in FAU's College of Business.
Rural hospitals are more likely than urban facilities to have access to telehealth, a once-underused service that now is playing a key role in treating coronavirus patients, according to research by two health administration professors in Florida Atlantic University's College of Business.
Neeraj Puro, Ph.D., and Scott Feyereisen, Ph.D., say the research can help U.S. hospitals understand the extent to which they are prepared for another wave of the pandemic. The work has been published in The Journal of Rural Health, one of the leading peer-reviewed publications on rural health issues.
Telehealth connects patients with doctors by computer or telephone when in-person appointments are not possible or safe from disease transmission.
"It's a relatively easy way to expand access," Feyereisen said. "More health care access is good. It's one of the goals of the system."
Having telehealth provides hospitals the ability to expand their service offerings in multiple ways, according to the report. For example, telehealth services have the potential to improve outcomes for high-risk obstetric patients in rural communities, while telehealth facilitated the use of anti-microbials in rural areas where infectious disease physicians were not available. Still, barriers such as insurance restrictions and technology limitations remain in place, preventing the widespread use of the service.
Puro and Feyereisen concluded that talking with doctors remotely is an important part of improving rural health care. The odds of hospitals to provide telehealth services vary, with Minnesota, Iowa, South Dakota, North Dakota, Nebraska, Missouri and Kansas leading the way among the nine regions designated by the U.S. Census.
What's more, coastal states, including New York, Florida, California and Washington, generally lacked the capability to provide e-services in rural areas, with telehealth specifically in short supply. In addition, telehealth capabilities are more common in hospitals that belong to a system and benefit from the economies of scale.
"Not only are rural populations some of the most vulnerable to diseases such as COVID-19, they might be called upon to provide back-up service to overflowing urban hospitals in the event such systems are overwhelmed," the report stated. "Going forward, telehealth is likely to play a large role in diagnosing patients, particularly in coming months as long as social distancing is a preferred strategy for preventing the spread of COVID-19. This virus might also become seasonal, and until a vaccine is introduced, telehealth will likely be increasingly integral to diagnosis and treatment."
The research also found that telehealth capabilities are predictably available in larger hospitals as well as teaching hospitals, and the professors say policymakers would be wise to provide support to smaller facilities.
The study of 3,268 hospitals is based on 2017 data from the American Hospital Association survey, Area Health Resource Files and Medicare cost reports.