Telehealth and Rural America

HRSA Administrator Dr. George Sigounas
HRSA Administrator, George Sigounas, MS, Ph.D. recently returned from a World Health Organization conference in Ireland, noted that "No matter where you are ... there are many similarities" in the burdens and barriers faced by rural dwellers around the world. One answer may be expanded telehealth. 

 

Karin Mack (left) and Arlene Greenspan from the CDC's National Center for Injury Prevention said in a webcast on Nov. 15 that rural America continues to be challenged by longer response times for emergency crews, greater distances to trauma centers and clinician shortages. But substance abuse among those under age 35 is sharply down in recent years, even as  it remains high among the middle-aged.
Karin Mack (left) and Arlene Greenspan from the CDC's National Center for Injury Prevention said in a webcast on Nov. 15 that rural America continues to be challenged by longer response times for emergency crews, greater distances to trauma centers, and clinician shortages. But substance abuse among those under age 35 is sharply down in recent years, even as it remains high among the middle-aged.

 

Noting that HRSA recently invested $203 million in health centers and rural communities to help fight the opioid epidemic, Dr. Sigounas said recently: "While the purpose of National Rural Health Day is to celebrate the efforts and contributions of rural America, it is difficult to think about rural health and not acknowledge the opioid crisis."

One response to the crisis, conferees said, is Project ECHO -- a new emphasis on telehealth as a means to deliver clinician training, patient consultation and case management to geographically isolated communities where hands-on care is scarce.

The CDC has attributed the rising incidence of suicide and drug overdose deaths in rural communities, in part, to a relative scarcity of preventive behavioral health care and drug treatment -- which experts now say could be addressed at a distance by experts in metropolitan areas, electronically.

Through the 2016 ECHO Act -- Expanding Capacity for Health Outcomes -- Congress has given HHS two years to identify opportunities to use technology-driven training to improve its programs. Some eight agencies within HHS are supporting 150 grants to test sites, said HHS Assistant Secretary for Planning and Evaluation Nancy DeLew.

Of all HHS Op-Divs, she added, HRSA has a long track record of incorporating telehealth and teleconferencing into its programs across its bureaus and offices. In the agency's Federal Office of Rural Policy, those efforts extend across decades, long before the digital age to the era of closed-circuit TV connectivity between remote providers and distant urban medical centers.

Through its health professional training programs alone, Dr. Sigounas observed, HRSA provided remote teaching sessions to roughly 185,000 students and clinicians through more than 8,000 training sites in rural communities nationwide last year.

 

Dr. Sigounas with Deputy Administrator Diana Espinosa and Tom Morris, Associate Administrator of the Federal Office of Rural Health Policy, a long-time champion of telehealth initiatives in rural America.
Dr. Sigounas with Deputy Administrator Diana Espinosa and Tom Morris, Associate Administrator of the Federal Office of Rural Health Policy, a long-time champion of telehealth initiatives in rural America.

 

Project ECHO began when the University of New Mexico Health Sciences Center adopted teleconferencing a decade ago to train rural primary care clinicians on how to treat  patients with hepatitis C -- a disease intimately related to IV drug use in the opioid era. It has since expanded to include training on the treatment of mental and substance use disorders, among other chronic conditions.

For recent CDC reports, see the MMWR Rural Health Series or visit the Rural Health Research Center.

Date Last Reviewed:  December 2017