JMIR Publications

ABSTRACT

Background:

The adoption of telehealth services has been a challenge in rural communities. The reasons for slow adoption of such technology-driven services have been attributed to social norms, healthcare policies, and a lack of infrastructure to support the delivery of services. However, the COVID-19 pandemic-related shutdown of in-person healthcare services resulted in the usage of telehealth services as a necessity rather than a choice. As services return to normalcy, it is important to examine if the usage of telehealth services during the period of a shutdown has changed any of the trends in the acceptance of telehealth as a reliable alternative to traditional in-person healthcare services.

Objective:

Our aim was to explore if the temporary shift to telehealth services has changed the attitudes towards the usage of technology-enabled health services in rural communities. The pandemic also fast-tracked some needed legislation to allow medical cost reimbursement for remote examination and healthcare services. An increase in the use of telehealth could help the local and federal governments address the shortage of healthcare facilities and service providers in underserved communities, and patients can get the much-needed care in a timely and effective manner.

Methods:

We examine the Medicaid reimbursement data for the state of Alabama from March 2019 through July of 2021. Selecting the telehealth service codes, we explore the adoption rates in three phases of the COVID-19 shutdown, including pre-pandemic, pandemic before the rollout of the mass vaccination, and pandemic after the rollout of the mass vaccination.

Results:

The trend of telemedicine claims has an opposite pattern of non-telemedicine claims across the three periods. The distribution of various characteristics of patients who have used telemedicine (age group, gender, race, level of rurality, and service provider type) are very different across the three periods. Claims related to behavior and mental health enjoyed the highest rates of telemedicine usage after the onset of the pandemic. The rate of telemedicine usage remained at a high level after the rollout of the mass vaccination.

Conclusions:

The current trends indicate that adoption of telehealth services is likely to increase post-Pandemic and that the consumers (patients), service providers, healthcare establishments, insurance companies, and state and local policies have changed their attitudes towards telehealth.