Coleman Drake, PhDAssistant Professor, Health Policy and ManagementPitt Public HealthUniversity of Pittsburgh Graduate School of Public Health

Telemedicine Expansion to Rural Areas Limited by Lack of Broadband Infrastructure Interview with:

Coleman Drake, PhDAssistant Professor, Health Policy and ManagementPitt Public HealthUniversity of Pittsburgh Graduate School of Public Health

Dr. Drake

Coleman Drake, PhD
Assistant Professor, Health Policy and Management
Pitt Public Health
University of Pittsburgh Graduate School of Public Health What is the background for this study? What are the main findings?

 Response: Telemedicine is frequently proposed as a solution to improve access to care in rural areas where driving to the nearest physician can take up to several hours. However, there needs to be sufficient broadband infrastructure for patients to actually use telemedicine. We found that broadband infrastructure is often insufficient to support telemedicine in the most rural areas, particularly in areas where there is inadequate access to primary care physicians and psychiatrists. What should readers take away from your report?

Response: Telemedicine has great potential to reduce barriers to access to health care. However, its potential will remain untapped in the areas where it has the greatest potential to improve health care access – rural areas where geographic access to care is limited – without requisite broadband infrastructure. My coauthors and I conclude that policymakers should consider the benefits of increasing access to medicine in deciding whether to expand telecommunications infrastructure in rural areas. What recommendations do you have for future research as a result of this work?

Response: Part of the reason broadband infrastructure is so important is that patients in rural areas often must travel to clinics where they can use telemedicine to have an appointment with a provider that is not physically at the clinic. We could focus on cellphone infrastructure expansion if public and commercial insurers reimbursed patients for telemedicine visits from their homes. It would be interesting to learn how patients’ utilization of telemedicine and health outcomes change when they can just pick up their phone to see their doctor. 

This study was funded in part by a Robert Wood Johnson Foundation grant that was awarded to Daniel Polsky. The authors have no other relevant disclosures. 


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

Published: Ann Intern Med. 2019.
DOI: 10.7326/M19-0283 May 21 2019

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Last Updated on May 22, 2019 by Marie Benz MD FAAD