To help improve access to healthcare services, many clinics have turned to technology. Telehealth has proven to be a useful tool for reaching rural populations and increasing access to primary care and specialty services. Connecting via a computer or tablet can efficiently overcome issues of distance and address healthcare provider shortages. Telehealth can also add a level of social connectedness, helping rural populations further overcome issues of isolation.109,110
Smartphone and computer applications can also assist healthcare providers to obtain immediate medical information. A smartphone intervention for pregnant patients has been studied to increase patient prenatal self-care in a cost-effective manner. Texting, chat functions, camera, and hyperlink functions can be used for prenatal care, patient education, and health promotion. Studies have shown that it has increased patient involvement in care and treatment adherence, and can potentially improve birth outcomes.111
Internet and e-health services have substantial potential to enhance health care for the elderly. Health information, patient education, prescription medication, and self-management tools are increasingly being made available to adults with chronic health conditions through smartphones, email, and computer applications.112
For transportation, healthcare organizations can contract with nonemergency medical transportation services to bring patients to medical appointments. Healthcare organizations can also bring medical care directly to rural patients through mobile screening units, such as mammography or mobile healthcare clinics.89
The cost of health care may be the largest issue facing rural residents as a result of the lack of public health care. Patients living in rural areas are disproportionately affected by regulatory and reimbursement changes to Medicare and Medicaid. Therefore, state and federal legislative actions are needed to offset healthcare costs for rural, impoverished residents.113
In May 2018, the Centers for Medicare & Medicaid Services (CMS) unveiled the Rural Health Strategy, a plan to take proactive steps to ensure rural communities receive quality and affordable access to healthcare. CMS is focused on accomplishing 5 goals through the new strategy: advance telehealth services, apply a rural lens to agency policies, improve access to care, empower rural patients to make healthcare decisions, and leverage partnerships to achieve these objectives.113
Lack of access to PCPs creates a myriad of health issues including lack of screening services, preventive healthcare measures, and health promotion. To reach this the goal of Health People 2020, healthcare providers have to fully comprehend the specific healthcare needs of the rural population. Incentives for medical school graduates, nurse practitioners, and physician assistants are recommended to fill the void in rural healthcare provision, and a strategy for improving the provision of rural health care in America is currently underway by CMS.
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