Are you tired of hearing about telehealth yet? As one of the many advocates of this exploding health care sector, I hope not.

Before the COVID-19 outbreak, telehealth represented a promising idea of what the future of medicine could look like. There would be no lounging around a waiting room, no awkward sprint around an unfamiliar medical office building in an attempt to be on time to your appointment. What’s more convenient than a check-up in your own home?

In the current era of a global pandemic, telehealth offers even more advantages. Not having to leave your house means you don’t risk spreading or catching infectious diseases like SARS-CoV-2. During the early stages of the pandemic when elective procedures were being limited to conserve medical supplies and resources, telehealth bridged a health care gap that provided patients with some sort of care during a time of high uncertainty.

I recently had my own first experience with telemedicine. I had COVID-19 in mid-March and needed to be cleared by a health care provider to go back to work. Since I am fortunate to live in a place where there are several options for high-speed internet, I was able to be seen via telehealth.
The physician’s assistant asked me some questions and sent me on my way within 10 minutes of the appointment beginning. A mere half an hour later, I had a letter in my inbox addressed to my HR department clearing me for work. I couldn’t believe how easy everything was to figure out and how quick the appointment was in comparison to all the other times I had been seen in-person by a health care provider.

Unfortunately, my experience isn’t one that all will have. In rural populations, telemedicine is one of the most promising yet simultaneously challenging health care approaches.

Since 2010, many hospitals in rural communities, especially in Florida and other southern states, have been forced to shut down due to financial hardship. Their closures have required patients to travel many miles to access health care and forced the underserved who do not have reliable transportation to go without medical care. It’s obvious why telemedicine could be a powerful tool in rural areas.

However, there are several barriers that prevent telemedicine from becoming a viable option throughout rural communities. Lack of high-speed internet and internet infrastructure is one of these challenges. According to a recent survey, 75% of U.S. adults who live in urban areas said they had home broadband versus only 63% in rural populations.
A second barrier to rural telemedicine is the variability in policy. Coverage is currently decided at the state-level and no two states have enacted the same policy. For example, Texas Medicaid provides reimbursement for three different forms of telemedicine but in Florida, Medicaid only covers two-way live videos.
The COVID-19 pandemic has forced legislators to take more immediate action. The CARES Act, passed in late March, attempts to improve upon the lack of internet infrastructure by allocating funds for improving internet access in rural communities.
 
More recently, a toolkit has been released to accelerate the adoption of broader telehealth coverage policies. In addition, a bipartisan group of senators co-authored a letter that urges lawmakers to permanently implement the policies in virtual health care that were enacted because of COVID-19.
The benefit of these policies and guidelines is yet to be determined and we may not understand the full impact for years to come, but I am hopeful they will begin to provide relief to a long-term problem.