Are remote area candidates for virtual health ironically less tech conducive?

Background: Telemedicine is increasingly considered an alternative delivery method for delivering specialist resources, monitoring acute and/or intensive statuses, self-managing chronic disorders, and delivering patient information and results.  Tele-medicine is particularly attractive for remote geographies, socio-economically disadvantaged areas, and/or areas with aged populations.  However, little research has examined if these areas are less tech-conducive. 

Objective/Purpose:  This research examines if telemedicine candidate (NC) counties more remotely located from major medical areas and corridors are ironically less tech-conducive. It also examines the correlation of death rates to county medical proximity and tech-conduciveness.

Methods: Access tier levels (ATLs) are assigned to counties based upon their proximity to major medical facilities.  Tech-conducive factors are calculated for each county based upon income, age, ethnicity, and education demographics from national, state, and county censuses and are then normalized into a relative tech-conducive scores (TCS) that are regressed and correlated.

Results: a) a significant weak relationship between NC county proximity and TCS for the state (β = .252^**, R² = .054^**), but a significant moderate relationship for the Piedmont region (β = .517^**; R² = .245^**; b) a moderate negative relationship between death rates and TCS (β = -.538^**, R² = .282^**); c) a moderate positive correlation between death rates and TCS (R = .392^**); d) a moderate positive correlation between medical proximity and agedness of the population (R = .366^**).

Discussion/Conclusion: A reverse relationship is indicated between counties’ proximity to major medical areas/corridors and their tech-conduciveness; less proximal counties are relatively less tech-conducive.  Understanding areas’ TCS and ATL could alter the application and/or configuration of telemedicine delivery and indicate tech-conducive changes that must occur prior to implementation.  There is a moderate positive correlation between death rates and tech conduciveness and between medical proximity and agedness; this warrants further socio-economic understanding and examination.