The uniqueness of the crisis forced telehealth adoption, but as the urgency stabilises, pandemic learnings must be captured, utilised, and built upon in a post-pandemic world. The aim of this study was to document staff experiences and perceptions of delivering rural psychological therapies via telehealth during the pandemic and to capture learnings for future rural telehealth delivery. Our findings suggest that telemedicine may not fully align with the specific needs of rural areas and should be optimized to address the limitations of rural practice.
Reliable Internet and Network Infrastructure
The healthcare of expectant mothers and newborn children benefits largely from telemedicine services which enhance lifesaving treatments across rural areas. In underserved areas maternal patients along with new infants do without timely medical assistance because healthcare professionals are scarce and access to transportation is limited while distance persists as a barrier. Historically, inconsistent reimbursement policies across Medicaid programs and private insurers have created uncertainty for healthcare providers. This lack of clarity can discourage providers from investing in telehealth infrastructure, especially in rural areas where patient volumes may be lower, raising concerns about the financial viability of such services. The positives of telehealth identified by practitioners in this study have been identified in studies in the UK, US, Canada and Australia 53,54,55.
There are inherent limitations in self-reported questionnaires, particularly related to social desirability bias. There is a risk that participants in this study felt compelled to answer positively, however, the results indicate that participants perceived benefits and barriers. In the UK, demands for urgent action to address health inequalities and poor health and well-being outcomes in rural and coastal areas are escalating 36, however, calls without concerted action are meaningless. Given the significant rural geography and millions of UK residents that reside outside urban cities, rural UK research and dissemination of learnings that demonstrate tangible and measurable health and wellbeing outcomes must be an urgent priority. This study makes a small contribution to embryonic rural UK research. A total of 62 respondents completed the questionnaire resulting in a response rate of 68%.
Availability of data and materials
- This approach improves health outcomes and reduces hospital admissions.
- As with anything you read on the internet, this article should not be construed as medical advice; please talk to your doctor or primary care provider before changing your wellness routine.
- For telemedicine in rural areas to be effective, collaboration with various stakeholders is essential.
- The questionnaire was piloted with four members of the IAPT team to ensure readability and face validity before distributing to all eligible staff.
According to a report by the Federal Communications Commission (FCC), approximately 22.3% of rural Americans lack broadband internet access, compared to only 1.5% in urban areas. Intermittent or slow internet speeds can disrupt video calls, rendering the technology ineffective. Investing in robust broadband infrastructure is thus crucial for maximizing telehealth’s potential in rural communities. Public health education plays a vital role in building trust and empowering individuals to seek the help they need. By fostering a supportive and informed community, we can ensure that telehealth becomes an integral part of rural healthcare, leading to improved mental health outcomes for all. As technology continues to advance and policy adapts to embrace telehealth, we can anticipate its increasing integration into rural healthcare systems, bridging the gap in access to care and ultimately promoting health equity throughout rural communities.
Many individuals in rural communities may be unfamiliar with telehealth technologies or lack access to necessary devices such as smartphones or computers. This digital divide can deter patients from utilizing telemedicine services, thereby limiting its reach and effectiveness. Our assessment revealed that telemedicine can facilitate access to specialty care by overcoming patient barriers and minimizing provider isolation. However, those implementing telemedicine should optimize its delivery to address rural-specific limitations. Telemedicine may be considered an adjunctive tool to high-quality, in-person care.
It now serves as a model for similar systems in countries such as Australia, Canada, Norway, and Japan 40,41,42,43. Rates of pandemic related anxiety, depression, post-traumatic stress disorder, psychological distress, and stress across the general population 24 25, 26, saw increased mental health service demand. This demand and reductions in service delivery due to COVID-19 controls, forced service providers to pivot rapidly to telehealth to maintain care delivery. While the rates of mental illness are comparable between rural and urban populations —approximately 22.7% of rural residents report a mental health condition—access to care is dramatically different. The sheer distances involved in reaching urban healthcare centers, often entailing multi-hour commutes, present a significant barrier for many.
Simple solutions such as having a professional with a client at the user end of telehealth and co-consultation situations would go a long way to improving the experience for both the client and the professional. This, of course, would take funding commitments but would be a small cost to ensure vulnerable rural people facing deprivation have the same rights of access as urban dwellers. The lack of digital infrastructure identified in this study has consistently been reported internationally across a multitude of health systems. In 2018 in the United Kingdom 1, building the best technology into health systems and ensuring that https://pin-upindia.com.in/ digital systems and people’s needs aligned were identified as critical.
HEALTHCARE RECRUITMENT AGENCY
In rural US, Svistova and colleagues 27 recommended hybrid models of service delivery rather than a return to all face-to-face. Additionally, these positives align with systematic reviews on the perspectives of clients, who see improved access and reductions in both the cost and time commitment major benefits of telehealth 18. Respondents indicated that there might be groups of people who could have difficulty engaging with telehealth and digital services. These were largely older adults, people with learning and sensory disabilities, as well as those in remote areas prone to poor phone signal and internet connectivity. Respondents were asked to compare telehealth services with services provided before COVID-19 and the move to telehealth in ten key areas (Fig. 1).
Lastly, it is possible to identify specific specialties in which telemedicine interventions may have the greatest impact. Fortunately, telehealth offers a transformative solution, bridging the geographical gap and democratizing access to mental healthcare. This remote care model is rapidly evolving, paving the way for a future where distance is no longer a deterrent to receiving essential mental health support from social workers, doctors, or other clinicians. The benefits are many, addressing several key challenges unique to rural populations. Here is what the future of telehealth might look like for rural areas in the next few years. While telemedicine interventions have aimed to address perceived needs, there is insufficient research assessing the actual specialty care needs of rural patients and providers, and how telemedicine can address them.
4 The US Congress rapidly overturned telehealth billing and reimbursement restrictions, enabled telehealth from people’s homes (including physicians), and expanded approved platforms 3. Similar changes were made in Australia 21, 22, Canada 4, 17, 19, and the UK 23. This mixed methods study included surveys and semi-structured interviews of rural primary care physicians (PCPs). Survey data were analyzed with summary statistics and cross-tabulations. Programs like the Tele Neonatology Network in the United States allow rural hospitals to access neonatologists remotely, reducing infant mortality rates. In Uganda, the UNICEF-supported mHealth program uses mobile technology to provide real-time consultations for pediatric care.
- More negative perceived impacts were the client’s ability to use and observe non-verbal communication as well as to maintain attention and focus.
- While local, in-person access to specialists remains a priority, telemedicine can reduce patient burdens and improve care when in-person specialists are unavailable.
- Finally, approaches such as clinic-to-clinic visits, also called facilitated, synchronous visits, may be a strategy to overcome patient barriers and optimize telemedicine use.
- The crisis of the COVID-19 pandemic, saw barriers rapidly overturned with the unprecedented and exponential rise in telehealth usage.
- Finally, digital literacy remains a barrier for some, particularly among older populations.
Remote Monitoring for High-Risk Pregnancies
Data in this study were collected over a three-month period (April-June 2021) which provides an understanding of how practitioners felt after one year of working with telehealth approaches rather than more immediate responses. Staff may have adjusted to delivering IAPT services via telehealth which could explain the high levels of satisfaction reported in this survey. In 2020, the COVID-19 pandemic saw an unprecedented and rapid overturning of many barriers and major acceleration of telehealth usage 3, 4, 17, 20,21,22. In May 2020, Dr. Sacha Bhatia stated, ‘… the COVID pandemic was the match that lit the fire around this revolution in virtual care’.
The Anti-Vegetables Generation: What It Reveals About Their Health Habits
The reported delivery of telehealth via both telephone and online video conferencing had significantly increased since the pandemic with 98% reporting the use of telephone and 89% video conferencing. Additionally, participant’s self-rated skill levels delivering telehealth via the telephone and using video conferencing had significantly improved compared to before the pandemic. Despite this, 58% reported no formal training for using telehealth at the time of data collection (Table 3). Key themes included benefits, concerns, and other priorities related to telemedicine. Primary care physicians highlighted improved access to care and reduced travel burden for patients.
Further research is needed on clinical outcomes in specialty-specific telemedicine interventions, the effectiveness of clinic-to-clinic visits, and telemedicine’s impact on the rural physician workforce. The aim of the study was to document staff experiences and perceptions of delivering rural psychological therapies via telehealth during the pandemic and to capture learnings for future rural telehealth delivery. Telehealth’s impact on mental healthcare in rural areas is profound. Mental health services, unlike many other medical specialties, often don’t require in-person physical examinations or complex diagnostic testing. Instead of arduous journeys to a clinic, patients can connect with therapists and counselors via video calls, receiving the same quality of care from the comfort and privacy of their homes. This convenience eliminates significant travel time and expense, making regular therapy sessions a feasible reality for many who previously lacked access.
Telemedicine in Rural Areas: A Lifeline for the Forgotten
Without a comprehensive understanding of rural needs, rapid telemedicine development may bypass populations it aims to serve and disrupt, rather than enhance, rural primary care practices. In the United States, the Maven Clinic offers telehealth services to high-risk expectant mothers, reducing hospital admissions and improving outcomes. In Rwanda, the Babyl Health telemedicine platform provides AI-driven pregnancy monitoring, ensuring that healthcare professionals can intervene at the right time. Telemedicine connects patients to specialists without requiring long-distance travel.
The predominantly rural county has a mixture of affluence and deprivation 35. Within the county, high rates of smoking, alcohol and drug use, and poor physical and mental health are evident in coastal and deprived communities. Rural, seasonal and coastal populations provide significant challenges to traditional modes of service delivery often based on urban modelling 36. In 2019, the UK Government released key policy on rural research priorities. They reinforced the diversity in rural UK and need for locally developed strategies, digital connectivity, and technology 34. The study described in this paper is a report of a major local strategy to address both mental health and rural isolation so is important in the genesis of embryonic UK rural research.
The research team collected data via survey and semi-structured interviews. The survey included questions about specialty care availability, frequency of specialty referrals, the perceived value of telemedicine in providing specialty care, and communication between PCPs and specialists. We conducted statistical analyses using SPSS; cross-tabulations described the relationship between specialty availability and referral frequency. Graphical representations using weighted averages show results of the cross-tabulations (Figure 1). The force response option in Qualtrics was used to ensure that participants did not overlook or miss any of the questions that were vital to the analysis. The future of telehealth in rural areas depends not only on technological advancements but also on strong community engagement and effective public health initiatives.
