Research: VA telehealth enlargement lagged in rural areas throughout COVID-19

A digital divide in telemedicine use between rural and concrete communities elevated after the onset of the COVID-19 pandemic, notably inside psychological well being integration companies, in response to a research printed in JAMA Community Open

The research evaluated 3.6 million psychological well being integration visits and 63.5 million main care visits throughout 138 Veterans Affairs healthcare techniques nationwide from March 16, 2019, to December 15, 2021.   

Throughout the cohort, 6.3 million distinctive sufferers with a median age of 61 years had been included within the research, of which 90.5% had been males. Nearly all of sufferers (66.3%) recognized as non-Hispanic White, whereas 17.2% had been non-Hispanic Black sufferers.

The observational research included 45 rural and 93 city VA healthcare techniques. 

Earlier than the pandemic, 34% of rural VA healthcare techniques used telemedicine for main care companies in comparison with 30% use in city areas. Nonetheless, after the onset of the pandemic, solely 55% of rural techniques used telehealth for primacy care in contrast with 61% in city areas.

For psychological well being integration companies, rural techniques reported better telemedicine use at 29% in contrast with city techniques at 25% earlier than the pandemic. As soon as the pandemic started, 76% of rural techniques used telehealth for this function, in contrast with 84% of city techniques. 

There have been few video visits pre-pandemic in rural and concrete healthcare techniques, 2% vs. 1%, respectively. These numbers elevated barely to 4% in rural areas and eight% in city areas post-pandemic. 

“Regardless of a coordinated federal response, the VA healthcare system’s expertise means that growing telemedicine use might go away rural sufferers in danger for poor entry to care. Future analysis and implementation efforts for healthcare techniques should handle rural-urban structural inequities (eg, web bandwidth) and think about tailoring expertise to encourage adoption amongst rural customers in any respect ranges (sufferers, clinicians and healthcare techniques),” the researchers wrote.

“As healthcare techniques more and more depend on telemedicine to ship mandatory medical companies, rural hospitals could also be topic to better operational challenges, and rural sufferers could also be topic to growing inequity in entry to care in contrast with their city counterparts.


Researchers famous limitations, together with the opportunity of misclassifying some rural sufferers. Additionally they lacked information on VA sufferers who acquired non-VA care of their group, which can be extra frequent for rural veterans.

Lastly, the research’s generalizability could also be restricted to well being techniques with early telemedicine infrastructure, although researchers famous the implications would possible apply to most techniques which have adopted telemedicine. 

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