Journal
JOURNAL OF RURAL HEALTH
Volume 37, Issue 4, Pages 801-811Publisher
WILEY
DOI: 10.1111/jrh.12534
Keywords
health information exchange; health information technology; patient engagement; rural health; telehealth
Categories
Funding
- NIA NIH HHS [R56 AG062315, R01 AG062315] Funding Source: Medline
- NICHD NIH HHS [P2C HD041041] Funding Source: Medline
- NIMHD NIH HHS [R01 MD011523] Funding Source: Medline
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The study found significant differences in telehealth adoption among hospitals located in rural, micropolitan, and metropolitan areas, with higher adoption rates in more urban areas. Rural hospitals were least likely to have telehealth systems with patient engagement capabilities and to report electronic availability of clinical information from outside providers. The study explained a significant portion of the rural/urban differences in telehealth adoption, services adopted, and barriers.
Purpose To assess telehealth adoption among hospitals located in rural and urban areas, and identify barriers related to enhanced telehealth capabilities in the areas of patient engagement and health information exchange (HIE) capacity with external providers and community partners. Methods We used the 2018 American Hospital Association (AHA) Annual Survey and IT Supplement Survey. We applied state fixed effects multivariate analyses and Oaxaca decomposition to estimate the variation of outcomes of interest by hospital geographies. Findings Our research showed substantial differences in telehealth adoption among hospitals located in rural, micropolitan, and metropolitan areas, where adoption rates increase with urbanicity. Rural hospitals were least likely to have telehealth systems with patient engagement capabilities such as the ability to view their health information online and electronically transmit medical information to a third party. They were also the least likely to report that clinical information was available electronically from outside providers. Our model explained 65% of the rural/urban difference in telehealth adoption, 55% of the number of telehealth services adopted, and 43%-49% of the rural/urban difference in telehealth barriers. Conclusion Findings demonstrated significant barriers to telehealth use among hospitals located in rural and urban areas. For rural hospitals, barriers include lack of HIE capacity among health care providers in the community, and lack of patient engagement capability.
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