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

Abstract

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.

Is Rural Kansas Prepared? An Assessment of Resources Related to the COVID-19 Pandemic

“…Based on prior literature, the nine RUCCs were grouped into three categories (referred to as “rurality categories”) with the following labels: metropolitan (RUCC 1 – 3), nonmetropolitan/urban adjacent (4 – 6), and rural (7 – 9). 15 – 20 …”

“…Based on prior literature, the nine RUCCs were grouped into three categories (referred to as "rurality categories") with the following labels: metropolitan (RUCC 1 -3), nonmetropolitan/urban adjacent (4 -6), and rural (7 -9). [15][16][17][18][19][20] Variables related to rural health networks were included. In Kansas, critical access hospitals (CAHs) are organized into state-designated rural health networks (Figure 1).…”

The Clinical Information Systems Response to the COVID-19 Pandemic

“…According to 2017 and 2018 American Hospital Association Survey data, more than 60% of hospitals reported adoption of some form of telehealth and more than 13% had tele-intensive care unit capabilities prior to the COVID-19 pandemic [ 55 ]. Prior to COVID-19, there was wide variation in deployment of telehealth infrastructure and utilization across the world and within individual countries, for example, in the USA there was slightly more utilization in rural areas [ 56 , 57 ]. Historically, the most commonly cited barriers to telehealth included poor reimbursement, lack of provider interest, regulatory barriers, lack of time or resources for training, insufficient telecommunications technology and infrastructure, privacy concerns, and patient preference for in-person care [ 55 , 58 59 60 ].…”

Cancer Imaging and Patient Care during the COVID-19 Pandemic

“…The use of telehealth (ie, virtual visits) has expanded substantially over the course of the pandemic. However, different geographical regions may have limited access to resources that would facilitate these types of visits ( 106 ). If patients do need to enter the clinic, mask mandates and other infection prevention measures are being implemented across the United States.…”