The Limitations of Poor Broadband Internet Access for Telemedicine Use in Rural America: An Observational Study

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Letters3 September 2019The Limitations of Poor Broadband Internet Access for Telemedicine Use in Rural America: An Observational StudyColeman Drake, PhD, Yuehan Zhang, ScM, Krisda H. Chaiyachati, MD, MPH, MSHP, and Daniel Polsky, PhDColeman Drake, PhDUniversity of Pittsburgh, Pittsburgh, Pennsylvania (C.D.), Yuehan Zhang, ScMUniversity of Pennsylvania, Philadelphia, Pennsylvania (Y.Z., K.H.C.), Krisda H. Chaiyachati, MD, MPH, MSHPUniversity of Pennsylvania, Philadelphia, Pennsylvania (Y.Z., K.H.C.), and Daniel Polsky, PhDJohns Hopkins University, Baltimore, Maryland (D.P.)Author, Article, and Disclosure Informationhttps://doi.org/10.7326/M19-0283 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Background: Fewer than 10% of U.S. physicians practice in rural communities, where 25% of Americans live (1). Yet, rural Americans may need more health care as they become increasingly older and sicker relative to their urban counterparts (2). Telemedicine has been proposed as a solution to improve access to care (3). Federal and state policymakers have enacted policies to expand telemedicine use among publicly and commercially insured beneficiaries. However, whether Americans with the poorest access to care have the necessary broadband Internet capability to fully benefit from telemedicine is unknown.Objective: To identify whether Americans with inadequate access to primary ...References1. Sharp D, Bond M, Cheek K, Wolff H. Quality of Life Impacts the Recruitment and Retention of Rural Health Care Providers. National Rural Health Association Policy Brief. Accessed at www.ruralhealthweb.org/getattachment/Advocate/Policy-Documents/QualityofLifeRecruitmentRetentionProvidersFeb2015.pdf.aspx?lang=en-US on 20 December 2018. Google Scholar2. University of North Carolina, Cecil G. Sheps Center for Health Services Research. NC Rural Health Research Program. Accessed at www.shepscenter.unc.edu/programs-projects/rural-health on 23 December 2018. Google Scholar3. Mehrotra A, Jena AB, Busch AB, Souza J, Uscher-Pines L, Landon BE. Utilization of telemedicine among rural medicare beneficiaries. JAMA. 2016;315:2015-6. [PMID: 27163991] doi:10.1001/jama.2016.2186 CrossrefMedlineGoogle Scholar4. Gresenz CR, Auerbach DI, Duarte F. Opportunities and challenges in supply-side simulation: physician-based models. Health Serv Res. 2013;48:696-712. [PMID: 23347041] doi:10.1111/1475-6773.12029 CrossrefMedlineGoogle Scholar5. Federal Communications Commission, Connect2HealthFCC. Data. Accessed at www.fcc.gov/reports-research/maps/connect2health/data.html on 23 January 2019. Google Scholar Author, Article, and Disclosure InformationAffiliations: University of Pittsburgh, Pittsburgh, Pennsylvania (C.D.)University of Pennsylvania, Philadelphia, Pennsylvania (Y.Z., K.H.C.)Johns Hopkins University, Baltimore, Maryland (D.P.)See Also: Editorial commentDisclosures: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M19-0283.Reproducible Research Statement: Study protocol, statistical code, and data set: Not available.This article was published at Annals.org on 21 May 2019. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoLeveraging Telehealth to Improve Health Care Access in Rural America: It Takes More Than Bandwidth Bruce Baird Struminger and Sanjeev Arora Metrics Cited byImpact of Reducing Data Plan Costs on the Digital Divide in China: A Digital Lifestyles PerspectiveLeveraging Every Door Direct Mail for remote recruitment of a rural Appalachian study Sample: Response rate and representativenessDisparities in Telemedicine Use Among Louisiana Medicaid Beneficiaries During the COVID-19 PandemicUsing data analytics for telehealth utilization: A case study in ArkansasRates of Primary Care and Integrated Mental Health Telemedicine Visits Between Rural and Urban Veterans Affairs Beneficiaries Before and After the Onse