Leveraging Digital Technology

Challenges arising from the COVID-19 pandemic have worsened an already inequitable distribution of health care providers across rural and urban areas. The pandemic increased rates of staff burnout and early retirement. It also forced nurses and others to drop out of the workforce to care for ailing family members or children who lost access to in-person school and child care. This abrupt contraction of the labor supply increased wage pressures, making it difficult for financially strapped hospitals to compete with other employers. Rural areas, already at a disadvantage with fewer health care providers per capita, experienced more severe workforce problems than their urban counterparts.

One way to improve the distribution of the health care workforce is to leverage technology. Digital technology that enables telehealth and telementoring programs can help rural providers, especially hospitals, reimagine how they provide health care and use the health care workforce.

During the COVID-19 pandemic, Congress and the administration temporarily waived many Medicare telehealth restrictions, which benefited patients and providers alike in both urban and rural areas. Although the full effects of these flexibilities remain to be seen, they have, at a minimum, increased patient access to care and incentivized providers to build their digital capabilities. As a result, many providers already have access to the infrastructure needed for telehealth and telementoring.

Although the rapid uptake of telehealth has opened new possibilities for the health care system, policymakers still need to address the barriers that prevent rural providers from adopting these technologies.

Against this backdrop, BPC examined the ability of three evidence-based programs leveraging digital technology—Project ECHO, telestroke, and tele-ICU—to relieve some of the pressures facing the rural health care workforce. In this brief, BPC also outlines several policy options, including regulatory and legislative reforms, that would increase the use of these programs. Although a variety of policy approaches are necessary to address the underlying drivers of workforce shortages, evidence-based telehealth and telementoring models have the potential to expand provider capacity.