Perceptions and Perceived Utility of Rural Emergency Department Telemedicine Services: A Needs Assessment

Oest, Sarah E R; Ahmed, Azeemuddin; Mohr, Nicholas M.

doi:10.1089/tmj.2019.0168

Cited by 14 publications

(6 citation statements)

References 37 publications

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“…For one, although there is demand for telehealth services in rural areas, rural ED providers perceive its usefulness in particular specialties and its anticipated frequency of use less favorably than their academic center counterparts; 6 clinician acceptance barriers in general can pose a threat to successful telehealth implementation. 7 Furthermore, it is apparent that demand and availability vary systematically by region, 6 and that other barriers, such as Internet connectivity, state reimbursement, technological, regulatory, insurance and geographic restrictions, play a role in limiting adoptions. [7][8][9][10] Recent popular press articles even call into question hospital telehealth readiness.…”

Section: Resultsmentioning

confidence: 99%

Telehealth Availability in US Hospitals in the Face of the COVID‐19 Pandemic

Puro

Feyereisen

2020

The Journal of Rural Health

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Background Telehealth is likely to play a crucial role in treating COVID‐19 patients. However, not all US hospitals possess telehealth capabilities. This brief report was designed to explore US hospitals’ readiness with respect to telehealth availability. We hope to gain deeper insight into the factors affecting possession of these valuable capabilities, and how this varies between rural and urban areas. Methods Based on 2017 data from the American Hospital Association survey, Area Health Resource Files and Medicare cost reports, we used logistic regression models to identify predictors of telehealth and eICU capabilities in US hospitals. Results We found that larger hospitals (OR(telehealth) = 1.013; P < .01) and system members (OR(telehealth) = 1.55; P < .01) (OR(eICU) = 1.65; P < .01) had higher odds of possessing telehealth and eICU capabilities. We also found evidence suggesting that telehealth and eICU capabilities are concentrated in particular regions; the West North Central region was the most likely to possess capabilities, given that these hospitals had higher odds of possessing telehealth (OR = 1.49; P < .10) and eICU capabilities (OR = 2.15; P < .05). Rural hospitals had higher odds of possessing telehealth capabilities as compared to their urban counterparts, although this relationship was marginally significant (OR = 1.34, P < .10). Conclusions US hospitals vary in their preparation to use telehealth to aid in the COVID‐19 battle, among other issues. Hospitals’ odds of possessing the capability to provide such services vary largely by region; overall, rural hospitals have more widespread telehealth capabilities than urban hospitals. There is still great potential to expand these capabilities further, especially in areas that have been hard hit by COVID‐19.

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Section: Resultsmentioning

confidence: 99%

Telehealth Availability in US Hospitals in the Face of the COVID‐19 Pandemic

Puro

Feyereisen

2020

The Journal of Rural Health

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“…Research conducted with academic and rural providers suggests that rural providers perceive they would use telemedicine less frequently and therefore should be involved in the design and implementation of telehealth programs to meet their needs and preferences. 53 Research conducted with rural patients provides evidence for high feasibility and acceptability for receiving certain telehealth services. 47 Evidence also suggests that rural residents are more likely to use telehealth than urban residents, yet overall telehealth utilization rates are very low.…”

Section: Discussionmentioning

confidence: 99%

System- and Individual-Level Barriers to Accessing Medical Care Services Across the Rural-Urban Spectrum, Washington State

Graves

Abshire

Alejandro

2022

Health�Serv�Insights

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Background: Residents of rural areas face barriers beyond geography and distance when accessing medical care services. The purpose of this study was to characterize medical care access barriers across several commonly used classifications of rurality. Methods: Washington State household residents completed a mixed-mode (paper/online) health care access survey between June 2018 and December 2019 administered to a stratified random sample of ZIP codes classified as urban, suburban, large rural, and small rural (4-tier scheme). For analyses, rurality was also classified into 2-tier schemes (rural/urban) based on ZIP code and county. Respondents reported availability of medical care services and system- and individual-level barriers to accessing services. Logistic regression models estimated the odds of reporting system- or individual-level barriers in accessing medical care services across rurality (4- and 2-tier schemes), adjusting for respondent characteristics, and weighted to account for survey design. Results: About 617 households completed the survey (25.7% response rate). Compared to urban residents (across all 3 schemes), more rural residents reported traveling to a distant city or town for medical care ( P < .001). Rurality was significantly associated with increased odds of facing system-level barriers. Respondents from small rural areas had greater odds access barriers for primary care (OR 7.31, 95% CI 1.84-29.09) and having no primary care provider (OR 11.37, 95% CI 3.03-42.75) compared to urban respondents. Individual-level barriers were not associated with rurality. Conclusions: To improve healthcare access across the rural-urban spectrum, policymakers must consider system-level barriers facing rural populations.

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“…Telehealth has been associated with improved access to specialists for patients in rural or underresourced settings and has been associated with improvements in metrics such as length of stay, reduced transfers, increased discharges, improved costs, and similar quality of care, as discussed above. [163][164][165][166][167][168][169][170][171][172] Barriers to telehealth in rural EDs have previously been described and cost is the most frequently cited. [173][174][175][176][177][178] In addition to patients in rural settings, telehealth may also play a role in improving access for other underserved populations.…”

Section: Enhancing Access For Underserved Populationsmentioning

confidence: 99%

Telehealth in emergency medicine: A consensus conference to map the intersection of telehealth and emergency medicine

Hayden

Davis

Clark

et al. 2021

Academic Emergency Medicine

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Introduction: Telehealth has the potential to significantly change the specialty of emergency medicine (EM) and has rapidly expanded in EM during the COVID pandemic; however, it is unclear how EM should intersect with telehealth. The field lacks a unified research agenda with priorities for scientific questions on telehealth in EM. Methods: Through the 2020 Society for Academic Emergency Medicine's annual consensus conference, experts in EM and telehealth created a research agenda for the topic. The multiyear process used a modified Delphi technique to develop research questions related to telehealth in EM. Research questions were excluded from the final research agenda if they did not meet a threshold of at least 80% of votes indicating "important" or "very important." Results: Round 1 of voting included 94 research questions, expanded to 103 questions in round 2 and refined to 36 questions for the final vote. Consensus occurred with a final set of 24 important research questions spanning five breakout group topics. Each breakout group domain was represented in the final set of questions. Examples of the questions include: "Among underserved populations, what are mechanisms by | 1453 HAYDEN Et Al.

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Perceptions and Perceived Utility of Rural Emergency Department Telemedicine Services: A Needs Assessment

Cited by 14 publications

References 37 publications

Telehealth Availability in US Hospitals in the Face of the COVID‐19 Pandemic

Telehealth Availability in US Hospitals in the Face of the COVID‐19 Pandemic

System- and Individual-Level Barriers to Accessing Medical Care Services Across the Rural-Urban Spectrum, Washington State

Telehealth in emergency medicine: A consensus conference to map the intersection of telehealth and emergency medicine

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