Health Center News

Disease Management and Telemedicine in Rural America

Julie-Potyraj (3)Our guest blogger today is Julie Potyraj,  Community Manager for the MPH@GW blog (  She is also a public health graduate student at The George Washington University.

There are many benefits to enjoying the peace and quiet of living in a rural setting. However, when it comes to taking care of one’s health, there can be a unique set of challenges.  For instance, staying healthy and disease-free can be a difficult proposition when there are few primary health care providers available or nearby, including oral health providers.  People who live in rural areas may also deal with different types of health issues than those who live in towns and cities, such as asthma, heart disease, diabetes, high blood pressure and exposure to farm-related chemicals.  Since screenings and checkups  that can catch a problem early are often neglected, conditions can become quite serious by the time they’re diagnosed—and chronic diseases may progress more rapidly.

According to the  National Rural Health Association (NRHA):

  • Even though nearly 25 percent of the population lives in rural areas, only about 10 percent of physicians practice there.
  • Individuals in rural areas are less likely to have employer-sponsored health care or prescription drug coverage.
  • On average, per capita income is $7,417 lower in rural areas than in urban areas.
  • 20 percent of nonmetropolitan areas don’t have mental health services compared to 5 percent of metropolitan counties.
  • Suicide rates among men in rural areas is much higher than in urban areas.
  • High blood pressure was reported to be higher in rural areas.

To some extent, telemedicine has helped bridge the access gap.  This method uses technology to link rural patients and providers to those in urban areas to increase access to care. With improvements in technology, advances in telecommunications systems, and the wide availability of affordable mobile devices, the use of telemedicine is booming across the country—with more than 15 million Americans receiving some type of remote care in 2015, according to the American Telemedicine Association (ATA).  Some health centers  in rural areas make use of telemedicine services with promising results. Community Health Care Systems, a health center in Sparta, GA,  for instance,  has been using the program to conduct electronic home visits.  Ravenswood Family Dentistry, a health center in San Mateo, California, has been using teledentistry to provide dental exams to children at a Head Start center in an area where dental care is limited, or dentists do not accept new Denti-Cal patients, according to a previous NACHC blog post.   However, a July 2015 study of California health centers by the Center for Connected Health Policy (CCHP), stated that most of the current reimbursement models for telemedicine pose a financial hardship.  The report also cited other challenges, such as shortages of providers, interoperability of data systems, and coding of telehealth claims and encounters.

To learn more, NACHC has published an issue brief about the telemedicine issues that affect health centers and their patient populations.