Slow Broadband Still Hinders Telehealth in Rural Areas
/By Crystal Lindell
Unfortunately, the same issue that makes it difficult for some people to access doctors in person can also make it difficult for them to access doctors via telehealth: living in a rural area.
A new study found that nearly 12 million Americans in 41 states lack access to broadband internet sufficient enough to access telehealth appointments — 88% of whom live in rural areas.
Researchers at the Universities of Vermont and Southern Maine say these “broadband deserts” or BBDs have broadband connections slower than 100/20 megabits per second. Their study, published in JAMA, also identified “ambulance deserts” (ADs) and “healthcare deserts” (HCDs) in the United States.
Nearly 950,000 people live in AD and HCD areas, but have sufficient broadband for telehealth. About 650,000 people live in areas that lacked all three: broadband, ambulance services, and healthcare.
Western states were the most impacted by these issues, and had the highest percentage of rural residents living in BBDs (32%).
Just because you live in a rural area doesn’t make you technologically illiterate. About 95% of rural households have a computing device and 88.5% have a broadband subscription. But their broadband speeds are modest compared to urban areas.
“This cross-sectional study found persistent broadband disparities across 41 states, especially in rural areas of the South and West, where limited internet infrastructure and broadband subscription rates compound challenges in accessing timely medical care,” researchers said..
“While broadband availability and subscriptions are prerequisites for telehealth, its presence does not inherently guarantee use. The findings suggest that the potential of telehealth to mitigate gaps in primary, specialty, and emergency care is constrained by inadequate infrastructure and broadband subscription rates.”
Researchers cited two examples of states that have helped close these access gaps, saying they could serve as a model for other states.
North Dakota now has near-universal fiber connectivity, which was achieved through cooperative broadband initiatives, state leadership, and early federal investments from programs like the American Recovery and Reinvestment Act.
New Hampshire also leveraged federal funds and local partnerships to rapidly expand high-speed internet to underserved communities.
“These success stories highlight the importance of sustained funding, community-driven networks, and state-level planning that includes assessment of burdensome regulations to enable universal broadband coverage,” researchers said.
Telehealth services grew by leaps and bounds during the Covid pandemic, when many doctors’ offices were closed and their patients were stuck at home. For a few years, the DEA even allowed telehealth to be used for prescribing opioids and other controlled substances. Those lenient DEA prescribing rules were eventually phased out.
This year Medicare also dropped telehealth coverage for most Americans, but allowed a carve-out for Medicare patients in rural areas to still make telehealth appointments.
Funding delays and policy debates are currently holding up $21 billion in federal funding for rural internet projects, as states await guidance from the Trump administration on how to the money should be spent.
