CEOs of rural healthcare facilities offer insight into telehealth adoption opportunities

Adoption of telehealth has been gradual across the U.S. However, the Affordable Care Act renewed interest in these services, and opened a window for adoption and policy change. As one of 14 federally-sponsored centers, the Heartland Telehealth Resource Center (HTRC) examined this intersection between healthcare systems in flux and their increasing need for efficient, cost-effective and integrated technology services. Over two months, HTRC staff interviewed 24 CEOs of rural midwestern hospitals and federally qualified health centers to understand the operational challenges facing rural facilities, as well as the barriers and facilitators to telehealth adoption.

Method: Using random stratified sampling, researchers completed 24 key informant semi-structured interviews based on short-answer and open-ended questions. Interviews were coded using Nvivo qualitative analysis software.

Results: Preliminary analysis indicates facilities were at various stages along the diffusion of innovation model. Twelve facilities were using telehealth, five were exploring, and six were not considering telehealth. Recruitment and retention of staff were key operational barriers identified (11/24). Interviews also illuminated a distinct tension between giving providers a decision-making role in technology adoption and recognition of providers’ own fears of being replaced by technology.  Other barriers such as patient acceptance were identified.

Conclusions: Rural healthcare facility CEOs recognize the need for support from providers. Interviews suggest ways telehealth not only benefits patients but providers as well. These may be critical provider recruitment and retention tools for rural healthcare facilities. Additionally, groups seeking to advance telehealth can educate providers and CEOs on the technology’s multiple uses and benefits.