1. THE IMPACT OF TELEMEDICINE ON RURAL HEALTH: A LITERATURE REVIEW
ASHLEY BRADLEY, BS & MARTHA DAVIS VIGNES, MA
SOUTHEAST ALABAMA AHEC
Abstract
The practice of telemedicine is designed to increase
access to healthcare through the innovative use of
telecommunication technology (Mair and Whitten, 2000).
When properly implemented, telemedicine can reduce service
barriers in rural areas and provide immediate access to
treatment that is efficient, high quality, and cost effective.
Health professional shortage areas along with increasing
healthcare costs and patient expectations have created the
demand to find alternative methods of health care delivery
(Mair and Whitten, 2000).
Telemedicine Techniques
Store and Forward (“e-care”) - the transmission of stored
patient data
Remote monitoring – transmission of patient data from sensors
and monitoring equipment
Interactive Telemedicine- interaction in real-time,
videoconferencing between a patient and a clinician
Telemedicine Equipment
Video Cart
Bluetooth Stethoscope
Exam Camera
Ultrasound extensions
• Abdominal
• Vascular
• Endocavity
Advantages & Barriers
Advantages:
 Increased access to care
 Less transportation issues
 Follow up appointments
 Prenatal care
 Specialty services close to
home
Projects in Alabama
ADPH Telemedicine Initiative - providing access to
telemedine in county health departments
Rural Health Association - increasing awareness for
telemedicine in rural Alabama
UAB Emedicine - urgent care service that enables patients to
use their desktop or mobile decide to interact with providers
(Greer, 2014)
North Alabama Neuro-Stroke Network - tele-stroke camera
system allowing neurologists in Huntsville to see and talk to
patients in real time at any affiliate hospital
Medical AIDS Outreach - doctors in Montgomery treat HIV
patients at satellite facilities in rural communities
Southeast Alabama Medical Center TeleStroke program -
partnership with 5 hospitals in the Wiregrass region to
provide comprehensive quality stroke care and prevention.
Telemedicine in Rural Communities
• Only 16/54 counties considered rural by the Alabama Rural
Health Association have hospitals with Obstetrical services.
• Only 1/12 Black Belt counties have a hospital with obstetrical
services.
• Alabama has 80 sites that provide telemedine throughout the
state (Yurkanin, 2016).
• Telemedicine is expected to increase the fairness and equality
of the distribution of services, because of the accessibility of
health services, especially in remote areas (Rine, Ohinmaa, &
Hailey, 2001).
• Telemedicine is an economic alternative to transporting
patients long distances to receive care.
Applying Telemedicine Practices
Awareness: Many patients and rural communities do not know
that telemedicine is an option. Become familiar with
Telemedicine programs in your area to refer patients and
community partners to.
Education: Promote or sponsor programs that teach providers
how to use telemedicine equipment.
Host: Host a telemedicine site in your office to increase access
to care in your community.
References
Greer, T. (2014). UAB Medicine launches state’s first online service to treat common medical conditions.
Retrieved from: https://www.uab.edu/news/focus-on-patient-care/item/5131-uab-medicine-launches-
state-s-first-online-service-to-treat-common-medical-conditions Retrieval date: June 20, 2016.
Mair, F and Whitten, P (2000). Systematic review of studies of patient satisfaction with telemedicine.
Information in Practice. BMJ volume 320 pp. 1517-1520.
Roine, R, Ohinmaa, A, and Hailey, D. (2001). Assessing telemedicine: a systematic review of the literature.
CMAJ 165(6) pp. 765-771
Yurkanin, A. (2016). Dailing up the doctor: Telemedicine gets a vital boost in Alabama. Retrieved from:
http://www.al.com/news/index.ssf/2016/03/dialing_up_the_doctor_telemedi.html. Retrieval date: June
20, 2016.
Barriers:
 Reimbursement
 Coordination
 Marketing of Services
 Bandwidth
 Availability of physicians
 Limitations of services