An analysis of telehealth in a post-pandemic rural, Midwestern community: increased comfort and a preference for primary care.

Abstract

Background: The COVID-19 pandemic accelerated the adoption of telemedicine, integrating it into mainstream healthcare, especially in underserved and rural areas. This study examines the implementation and perceptions of telehealth in a rural Midwestern community in the post-pandemic period. Rural populations often face unique healthcare challenges. Telehealth has the potential to mitigate these issues by improving healthcare accessibility and patient satisfaction, thus being a vital topic for research.

Methods: A survey was created and conducted from September to October 2023 to evaluate Internet access, telehealth usage, and perceptions among residents of a rural Midwestern county. The county received fiberoptic Internet in November 2021, offering a valuable glimpse at the impact of advanced internet. The survey, distributed both online and in person, garnered 253 valid responses. Statistical analyses, including chi-square tests, were performed using IBM SPSS to explore the relationships between survey responses.

Results: Among the 253 participants, the majority were female (81.4%) with a median age of 50 years. Internet access varied, with 22% of paper survey respondents lacking home Internet compared to 1.3% of online respondents. Telehealth usage for participants increased from 5% pre-pandemic to 42.1% during the pandemic, with 21.8% continuing to use telehealth post-pandemic. Primary care visits were the most common telehealth appointments. Key concerns included a preference for in-person care and perceived lower quality of telehealth services. Despite these concerns, 59.7% of respondents were willing to use telehealth, rising to 67.5% if recommended by a healthcare provider. Comfort with telehealth was significantly linked to perceptions of Internet speed and stability.

Conclusions: While broadband and fiberoptic Internet are associated with better telehealth experiences, other types of Internet also facilitated telehealth usage in our study, indicating that factors beyond access influence patient comfort and willingness to use telehealth. Our findings also reveal significant interest in telehealth for primary care, suggesting rural patients prefer familiar providers for telehealth interactions. Despite increased telehealth interest and usage during the pandemic, a decline post-pandemic indicates potential barriers exist, such as limited availability of healthcare providers. Exploring and addressing these barriers remains crucial for sustaining telehealth adoption and improving healthcare access in rural communities.