Dive Brief:

• Rural Americans are going online for a variety of health-related services, but wider availability of high-quality broadband will be necessary to meet future telehealth demand, according to a new U.S. Department of Agriculture report.
• USDA analyzed data from the July 2015 Current Population Survey, which included 130,000 people age 15 and older. Of those, 19% researched health issues online. Urban residents were somewhat more likely than rural residents to conduct online searches, at 20% versus 17%. 
• Rural residents also lagged behind urban residents when it came to paying medical bills online, communicating with providers and performing other online health maintenance tasks (7% versus 11%) and in online health monitoring (1.3% versus 2.5%).

Dive Insight:

Telehealth is particularly promising for rural areas due to doctor shortages, hospital closings and lack of reliable transportation options. It allows people to be more engaged in their own health while facilitating care of minor ailments and monitoring of chronic conditions. Some regulatory and reimbursement barriers remain, but surveys showing people like telehealth and growing evidence that it works could help break those down.

CMS' final Physician Fee Schedule for 2019, released last week, adds payments for a number of new telehealth services, including prolonged preventative services, virtual check-ins and evaluations of photos and videos submitted by patients. A CMS proposal would also expand coverage telehealth services for Medicare Advantage plans.

While income was not a factor in how much people conducted online health research, education was. Nearly 30% of college-educated respondents did online research, compared with 13% of those with a high school diploma, the analysis showed.

With online health maintenance, both income and education played a role, with more educated and well-to-do respondents conducting more tasks online. Rates of online health monitoring also went up as income rose.

The analysis also points to technology challenges for rural Americans. While smartphones outnumber personal computers in the general population, PCs are more common than smartphones in rural areas — 83%-89% versus 79%. Yet access to high-quality broadband services can be a problem.

People seemed eager to conduct telehealth activities even when they lacked internet service in the home. For example, 13% of rural residents and 16% of urban residents who lacked a desktop computer said they still researched health topics online.

"In-home broadband Internet access, whether by choice or happenstance, may not have been a significant factor in 2015 for either rural or urban residents. Many still conducted health activities although they had no Internet subscription," the report says. "Health providers, however, continue to improve their offerings, so needs for high-quality household broadband service will likely increase if patients are to avail themselves of these new services, especially in rural and poor areas where lower quality broadband Internet service tends to be more common."