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The Rural Telehealth Initiative: Lowering Barriers to Health Care

For me, a visit to the doctor can be an inconvenience. Between fighting traffic, finding a parking spot, checking in and doing time in the waiting room, I usually have to carve out an hour or more of my day, all for about 15 minutes of quality time with the doctor. Sometimes I wonder–what’s the point of extending my life if I have to spend that precious extra time in the waiting room?

I complain, but I’m lucky. I live in Gainesville and work on the UF campus, where access to world-class health care is a lunch-break away. For people who live in Florida’s rural areas, a checkup or a simple consultation with a healthcare professional might require an all-day—sometimes an overnight—excursion. For many, that’s more than an inconvenience. It’s a barrier—one with life-threatening implications.

There’s a widening health gap between rural and urban communities. According to the CDC, rates for the five leading causes of death in the U.S.—heart disease, cancer, injuries, chronic lower respiratory disease and stroke—are higher in rural communities. There are economic and social factors behind this, but a chief reason is that there are simply fewer health care services available to rural residents. For example, in Dixie County, there are only 6 physicians for every 100,000 people (compared with the state average of 315 physicians for every 100,000). Because access to health care is so limited, people living in rural areas are less likely to get screened for cancer, are less likely to know their kids’ blood-sugar levels, and are more likely to delay or avoid care until the late stages of disease. As a result, Dixie County ranks 59th out of 67 Florida counties for health factors, including health behavior, access to clinical care, social and economic factors, and the physical environment.

Telemedicine—using online medical services—is one way to reduce health disparities, and since the COVID-19 pandemic it’s become an increasingly popular way to visit the doctor. But telemedicine devices are expensive and many people in rural areas don’t have access to the bandwidth needed for online consultations.

UF/IFAS Extension, in collaboration with UF Health, is in a position to help lower the barriers to health care in Florida’s rural counties. We have Extension offices in every Florida county, so chances are there’s an office closer to your home than the nearest hospital, clinic or private practice.

Beginning this fall, current UF Health patients living in 13 rural Florida counties will have the option of conducting online medical visits from their local Extension office. As part of the Rural Telehealth Initiative, a pilot program funded by a three-year USDA grant, these offices will be equipped with TytoCareTM telehealth kiosks that connect patients with their doctors in real time.

Each telehealth kiosk includes a headset; a camera for visual inspection; remote diagnostic equipment including stethoscope, otoscope, basal thermometer, tongue depressor, blood pressure cuff; and an iPad.

The kiosk is like a doctor’s office that fits in a box. It includes a high-definition camera and diagnostic equipment that allow you to send your doctor temperature, blood pressure, pulse, weight, heart and lung sounds and other basic biometrics. The equipment is sanitized and the rooms are private and come with boosted internet service. Trained Extension agents and staff are on hand to assist with learning how to use the equipment and connect online. Once the connection is secure, agents step out of the room and patients can enjoy a private consultation with their healthcare providers.

After their appointment is over, patients can also learn about Extension programs that support their health care goals. These can range from taking charge of diabetes, to horticulture therapy for cancer patients, to financial guidance for managing healthcare bills. In Extension, we know that medical care is just one part of the picture. Real health and wellness comes from our whole environment–the food we eat, the activities we enjoy, our work, our families, our finances. It includes both mental and physical health. Our research-based educational programs are designed to help people of all ages and backgrounds take charge of the many the factors that affect their health.

Telehealth kiosk unveiled at UF/IFAS Extension Liberty County, July 8, 2021. Pictured left to right: District Extension Director Pete Vergot; County Extension Director Marie Arick; Extension Agent Amy Mullins; Liberty County Commissioner Hannah Causseaux; UF Vice President for Agriculture and Natural Resources J. Scott Angle; Legislative Assistant to Sen. Lauranne Ausley, Melissa Durham; and Associate Dean for UF/IFAS Extension Mike Gutter.

The Rural Telehealth Initiative has the potential to save patients and their families hundreds of dollars and lower the hurdles that might prevent them from seeking the health care attention they need. We hope that as the program expands, more people will take advantage of their local Extension office to be proactive about their health.

If you’re a current UF Health patient living in one of the pilot counties (see map), ask your provider about scheduling a telehealth appointment through your local UF/IFAS Extension office.

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