As part of the Northeastern and Upstate California Connect Consortia (NECCC & UCCC) efforts to expand broadband services in rural Northern California and to support the California Telehealth Network (CTN) to expand its network and services to more rural health care facilities, Dr. Celeste Jones, CSU Chico Professor, created a survey to allow learning the status of telehealth services and challenges that prevent these health care facilities from adopting and implementing these services. The Geographical Information Center (GIC) and Center for Economic Development (CED) partnered to generate a list and map of rural health care facilities in the ten consortia counties and reached out to these facilities to conduct the survey. The following paragraphs summarize the survey results and findings.
With the lack of healthcare options, limited access to specializations, and the number of uninsured, an opportunity to evaluate the current status of telehealth in rural Northern California became available. A survey was created and a sample size of 40 respondents. Although the sample size did not provide an adequate number for any statistical significance or generalizations, the data does create an initial assessment of potential issues and barriers associated with delivering broadband and telehealth services to rural and isolated communities. This survey is the first step in a larger investigation of telehealth service delivery in Northern California.
Respondents indicate that a majority of on-site providers have ‘presenting site video conferencing’, utilize psychiatric, mental/behavioral services for diagnosing and treatment or as follow-up care. Off-site providers use their telehealth for clinical labs, experience connectivity barriers, and purchase their equipment through public grants or purchase through general operating funds. The on-site only facilities identified Inability to Connect at the Needed Bandwidth as one of the largest barriers; while off-site providers stated the only barrier was the Lack of Community/Patient Acceptance of Telehealth.
A number of challenges are presented when using telehealth and technology; however, there is an opportunity to address the promise of telehealth improving access and increasing quality of care. Increased awareness of CTRC can be provided through public service announcements, workshops, trainings, and education on the telehealth services designed specifically for each rural area. Along with education, technical support is critical for rural providers to become comfortable implementing a new form of healthcare delivery. With CTRC involvement, there can be support with technical concerns, funding resources, grants, private funding, and political advocacy. Additionally, legislation can be implemented to support telehealth usage. S. B. AB 1264, Petrie-Norris. Medical Practice Act: dangerous drugs: appropriate prior examination (2019) can reinforce the use of a telehealth delivery system. This bill specifically indicates telehealth as a means for receiving approval for this medication. The political support and policy development regarding key issues of telehealth is an essential element needed for telehealth to evolve (Klink et al., 2015).
Finally, telehealth is at a critical juncture as it advances from a tool used intermittently to an integrated tool on a routine basis (Klink et al., 2015). The overall findings of this inventory confirm that more research is needed on telehealth services and implementation models. Further investigation into the effectiveness, cost savings, and quality of telehealth is needed.