Telehealth Availability in US Hospitals in the Face of the COVID-19 Pandemic

J Rural Health. 2020 Sep;36(4):577-583. doi: 10.1111/jrh.12482. Epub 2020 Jun 30.

Abstract

Background: Telehealth is likely to play a crucial role in treating COVID-19 patients. However, not all US hospitals possess telehealth capabilities. This brief report was designed to explore US hospitals' readiness with respect to telehealth availability. We hope to gain deeper insight into the factors affecting possession of these valuable capabilities, and how this varies between rural and urban areas.

Methods: Based on 2017 data from the American Hospital Association survey, Area Health Resource Files and Medicare cost reports, we used logistic regression models to identify predictors of telehealth and eICU capabilities in US hospitals.

Results: We found that larger hospitals (OR(telehealth) = 1.013; P < .01) and system members (OR(telehealth) = 1.55; P < .01) (OR(eICU) = 1.65; P < .01) had higher odds of possessing telehealth and eICU capabilities. We also found evidence suggesting that telehealth and eICU capabilities are concentrated in particular regions; the West North Central region was the most likely to possess capabilities, given that these hospitals had higher odds of possessing telehealth (OR = 1.49; P < .10) and eICU capabilities (OR = 2.15; P < .05). Rural hospitals had higher odds of possessing telehealth capabilities as compared to their urban counterparts, although this relationship was marginally significant (OR = 1.34, P < .10).

Conclusions: US hospitals vary in their preparation to use telehealth to aid in the COVID-19 battle, among other issues. Hospitals' odds of possessing the capability to provide such services vary largely by region; overall, rural hospitals have more widespread telehealth capabilities than urban hospitals. There is still great potential to expand these capabilities further, especially in areas that have been hard hit by COVID-19.

Keywords: COVID-19; access to care; demography; technology; telehealth.

MeSH terms

  • Attitude of Health Personnel
  • Betacoronavirus
  • COVID-19
  • Coronavirus Infections / epidemiology
  • Coronavirus Infections / therapy*
  • Electronic Health Records / organization & administration
  • Health Services Accessibility / organization & administration*
  • Hospitals, Rural / organization & administration*
  • Humans
  • Pandemics
  • Pneumonia, Viral / epidemiology
  • Pneumonia, Viral / therapy*
  • Rural Health Services / organization & administration
  • Rural Population / statistics & numerical data*
  • SARS-CoV-2
  • Telemedicine / statistics & numerical data*
  • United States