Healthcare From Anywhere: Telehealth Use & Perceptions in Rural Michigan

 Study Finds Expanding Telehealth in Just Five Michigan Counties Could Mean Nearly $4.7 Million in Savings Per Year

Click the above image to view the full study or download the pdf.

Lansing, MI. (March 5, 2020) – Connected Nation Michigan (CN Michigan) just released a groundbreaking study that closely examines the use and perceptions of telehealth in rural areas.

“Our nonprofit has long been focused on connecting more families and communities to high-speed internet,” said Eric Frederick, Executive Director, CN Michigan. “In recent years, we’ve seen more talk about the ways telehealth could help fill the void in rural areas where there may not be hospitals or doctors for hundreds of miles. But, as we looked around for more detailed information on telehealth in Michigan, we soon learned there were a lot of unanswered questions at the intersection of telehealth and the Digital Divide that we decided to set out and answer.”

The more than six-month-long study was done in partnership with AARP and the Michigan Health Endowment Fund. Find the full report at http://bit.ly/2ThWBPX.

The study looks at the opportunities and reasons for expanding telehealth as well as the obstacles for rural areas.

“Many older adults in Michigan, especially those who live in rural areas, do not have access to high-speed internet, and that’s a quality of life issue for them,” said Paula D. Cunningham, State Director of AARP Michigan. “That means they can’t take advantage of advances in telemedicine that at the very least could save them long trips to the doctor, and at the most could be lifesaving.”

CN Michigan’s researchers took a three-pronged approach to examine those issues. First, they analyzed access to primary care physicians and health outcomes in Michigan and similarly rural states to states’ telehealth policy structure. This led to the identification of counties ripe for leveraging the benefits of telehealth.

Second, the team conducted random digital dial telephone surveys of 2,001 adult heads of households in five rural Michigan counties: Gladwin, Sanilac, Roscommon, Osceola, and Dickinson.

“We chose these five counties because they represent a cross-section of rural portions of the state,” said Chris McGovern, Director, Research Development, Connected Nation (CN). “They were selected due to their differences and representative nature in terms of geography, employment, and the prominence of non-related healthcare provision networks in each county. We focused our questions on current telehealth usage, savings experienced from accessing online healthcare, interest in future use of telehealth services, and barriers that prevent individuals from using the technology.”

The third facet of this study focused on providers. CN Michigan conducted extended interviews and focus groups with healthcare networks, including doctors, nurses, medical assistants, and others within the five counties identified for telephone surveys. Healthcare networks in these groups ranged from just beginning to experiment with telehealth to those with established and award-winning telehealth programs.

“As we continued our interviews, data collection, and focus groups, we began to see some trends emerge,” said Frederick. “Even though each community may have some unique challenges, there were some clear relationships that emerged. These included, among other things, counties with a population-to-primary-care-physician ratio of 2,500-to-1 or higher in states with ‘restrictive’ telehealth policies tend to have lower-than-average life expectancy and a higher-than-average rate of preventable hospital stays than the rest of the country.”

Counties with a greater Digital Divide, i.e. a lack of access to high-speed internet (broadband), also had a higher average ratio of residents per physician. By comparison, states with progressive state telehealth policies are more connected and fare better on both the socioeconomic and infrastructure indices that compose the Digital Divide Index (DDI) developed by Purdue University researcher Dr. Roberto Gallardo.

“This study demonstrates yet another important reason why connecting rural Michigan is critical,” said Frederick. “Connected Nation Michigan has worked for more than a decade to identify innovative solutions for connecting every community in the state. We’ve seen firsthand that having access to high-speed internet impacts everything from the economy to educating our children. Now we have real data that shows it can also impact healthcare—and even life expectancies—among those living in our rural communities and small towns through telehealth applications and programs.”

Key findings from the study:

• Among 1,374 counties in 18 states, counties that are deemed “Care Underserved” (often rural and/or low-income) have an average ratio of 4,758 residents per primary care physician.

• In the five, Michigan counties surveyed, telehealth usage represents a savings of nearly $4.7 million per year, just for simple 15 minute visits to general practitioners.

• With studies showing that the average doctor’s visit requires approximately two hours between travel, waiting rooms, and the visits themselves, this represents nearly $1 million ($985,000) in lost productivity per year, totaling a savings of $5.7 million per year in these five counties alone.

• Interacting via a website is the most popular way to use telehealth (36%), followed by interacting via email (34%), text messaging (17%), mobile apps (12%), video conferencing (4%), and social media (4%).

• The top barrier to telehealth usage was a concern about the privacy of the information they share. For others, the potential cost, or the potential risk that some costs would not be covered by their insurance or payer, gave them cause for concern.

Six key issues that must be addressed to improve and expand telehealth services in Michigan:

• Access to and use of home broadband service is often too low in rural areas for telehealth to be reliably implemented.

• Rural Michiganders have concerns about the safety of their online information.

• Telehealth services are not reimbursed at all or are reimbursed at a lower level than in-person healthcare services.

• Healthcare providers need additional funding to support expansion and improvement of telehealth services.

• Telehealth technology must become more integrative by adopting and learning how to use new tools and procedures for each telehealth application.

• Support for telehealth in Michigan is scattershot and needs to be more organized and targeted.

There are hundreds of key data points, which can be found at http://bit.ly/2ThWBPX. To learn more about CN Michigan head to connectednation.org/Michigan; to learn more about CN head to connectednation.org.