The Last Mile
COVID-19, Telehealth, and Broadband Disparities in Rural Indiana
DOI:
https://doi.org/10.18060/24844Keywords:
COVID-19, telehealth, broadband, access, rural, Indiana, infrastructure, disparitiesAbstract
This critical review of literature evaluates the impact of COVID-19 on health and mental health care delivery in rural Indiana, specifically the move to increased telehealth services. Telehealth has been a mostly positive experience for patients and providers. However, many Indiana residents are without the option of telehealth due to underdeveloped infrastructure that is necessary to support broadband access. This disparity is evidence of a larger social and health justice issue and illuminates a call to action for social workers on all levels to collaborate with community members, government agencies, and local programs to push the issue towards the public health arena and to promote broadband access as a human right.
References
Bauerly, B. C., McCord, R. F., Hulkower, R., & Pepin, D. (2019). Broadband access as a public health issue: The role of law in expanding broadband access and connecting underserved communities for better health outcomes. Journal of Law, Medicine & Ethics, 47(2_suppl), 39-42. https://doi.org/10.1177/1073110519857314
Carey, L. (2020). Tech for telehealth is only part of the equation, broadband access is the other. The Daily Yonder. https://dailyyonder.com/tech-for-telehealth-is-only-part-of-the-equation-broadband-access-is-the-other/2020/10/13/
Center for Connected Health Policy. (2018). A framework for defining telehealth. https://www.cchpca.org/sites/default/files/2018-10/Telehealth%20Definintion%20Framework%20for%20TRCs_0.pdf
Centers for Disease Control and Prevention [CDC]. (2017a). About rural health. https://www.cdc.gov/ruralhealth/about.html
CDC. (2017b). Rural Americans at higher risk of death from five leading causes. https://www.cdc.gov/media/releases/2017/p0112-rural-death-risk.html
CDC. (2020). How rural communities can respond during COVID-19. https://www.cdc.gov/coronavirus/2019-ncov/need-extra-precautions/other-at-risk-populations/rural-communities.html
Cohen, B., & Monte, S. (2020, April 3). Telehealth updates and information in Indiana. NASW IN. Online webinar, Indianapolis, IN. https://cdn.ymaws.com/www.naswin.org/resource/resmgr/trainings&cehs/teletherapy_and_covid_19_in_.pdf
Crume, J., & Willis-Gidley, L. (2020, June 29). Better together! Eliminating barriers to focus on whole child health through the integration of micro clinics and telehealth in rural schools. Indiana School Health Network Conference, Indianapolis, IN. https://www.ckfindiana.org/wp-content/uploads/2020/11/Better-Together.pdf
Dearinger, A. (2020). COVID-19 reveals emerging opportunities for rural public health. American Journal of Public Health, 110(9), 1277-1278. https://doi.org/10.2105/ajph.2020.305864
Duffy, C., & Tappe, A. (2020, May 17). America’s surprising breeding ground for inequality: The internet. CNN Business. https://www.cnn.com/2020/05/17/economy/internet-access-universal-wifi/index.html
Fairchild, M. (2020, June 29). 2020 school health legislation updates. Indiana School Health Network Conference, Indianapolis, IN. https://www.ckfindiana.org/wp-content/uploads/2020/11/2020-School-Health-Legislation-Updates.pdf
Fairchild, R. M., Ferng-Kuo, S. F., Rahmouni, H., & Hardesty, D. (2020). Telehealth increases access to care for children dealing with suicidality, depression, and anxiety in rural emergency departments. Telemedicine and e-Health: the official journal of the American Telemedicine Association, 26(11), 1353-1363. https://doi.org/10.1089/tmj.2019.0253
Federal Communications Commission [FCC]. (2017). Mapping broadband health in America 2017. https://www.fcc.gov/reports-research/maps/connect2health
FCC. (2020). FCC fights COVID-19 with $200M; Adopts long-term connected care study. https://www.fcc.gov/document/fcc-fights-covid-19-200m-adopts-long-term-connected-care-study
Fishpaw, M., & Zawada, S. (2020). Telehealth in the pandemic and beyond: The policies that made it possible, and the policies that can expand its potential. Heritage Foundation Backgrounder (No. 3510). http://report.heritage.org/bg3510
Glenn, L. (2020). Telecounseling turns a corner: What COVID shutdowns have wrought for remote practice. Social Work Advocates. https://www.socialworkers.org/News/Social-Work-Advocates/2020-August-September/Telecounseling-Turns-a-Corner
Good Therapy. (2020, March 26). Is there a shortage of mental health professionals in America? https://www.goodtherapy.org/for-professionals/personal-development/become-a-therapist/is-there-shortage-of-mental-health-professionals-in-america
Hirko, K. A., Kerver, J. M., Ford, S., Szafranski, C., Beckett, J., Kitchen, C., & Wendling, A. L. (2020). Telehealth in response to the COVID-19 pandemic: Implications for rural health disparities. Journal of the American Medical Informatics Association, 27(11), 1816-1818. https://doi.org/10.1093/jamia/ocaa156
Hovis, J., Baller, J., Talbot, D., & Blake, C. (2020, October). Public infrastructure/private service: A shared-risk partnership model for 21st century broadband infrastructure. Benton Institute for Broadband & Society. http://benton.org/publications/public-infrastructureprivate-service
Indiana Health Coverage Programs. (2020). IHCP issues telemedicine billing guidance for providers during COVID-19 outbreak. IHCP Bulletin, March 19, 2020, http://provider.indianamedicaid.com/ihcp/Bulletins/BT202022.pdf
Indiana Rural Health Association. (2019). Crossroads partnership for telehealth. https://www.indianaruralhealth.org/services/crossroads-partnership-for-telehealth/
Indiana State Rural Health Plan. (2012). Indiana state rural health plan. https://www.in.gov/isdh/files/Indiana_State_Rural_Health_Plan_2012.pdf
Jaffe, D. H., Lee, L., Huynh, S., & Haskell, T. P. (2020). Health inequalities in the use of telehealth in the United States in the lens of COVID-19. Population Health Management, 23(5), 368-377. https://doi.org/10.1089/pop.2020.0186
Kennedy, N. R., Steinberg, A., Arnold, R. M., Doshi, A. A., White, D. B., DeLair, W., Nigra, K., & Elmer, J. (2020). Perspectives on Telephone and Video Communication in the ICU during COVID-19. Annals of the American Thoracic Society, (2020, November 12). https://doi.org/10.1513/annalsats.202006-729oc
Martinsen, K. (2020, August 31). Rural COVID resources. Human Resources and Services Administration/American Public Health Association. American Public Health Association Rural Workgroup [Online webinar]. http://connect.apha.org/library.htm?mode=view&did=661175&lid=5&wf=416474
Morgan, A. (2020, November 19). 2020 mid-year rural health policy roundup. National Rural Health Association/Arizona Telemedicine Program [Online webinar]. https://swtrc.wistia.com/medias/ibm75keb9o
National Association of Social Workers and Association of Social Work Boards [NASW & ASWB]. (2005) NASW & ASWB standards for technology and social work practice. https://issuu.com/ss1fpce/docs/naswtechnologystandards
NASW & ASWB, Council on Social Work Education, & Clinical Social Work Association. (2017). NASW, ABSW, CSWE & CSWA Standards for Technology in Social Work Practice. https://www.socialworkers.org/LinkClick.aspx?fileticket=lcTcdsHUcng%3d&portalid=0
National Quality Forum. (2020). Rural telehealth and healthcare system readiness committee program overview. http://www.qualityforum.org/ProjectDescription.aspx?projectID=93747
Office of Community and Rural Affairs. (2020). Next level connections broadband program. State of Indiana. https://www.in.gov/ocra/nlc.htm
O’Dowd, E. (2018). Lack of broadband access can hinder rural telehealth programs. HIT Infrastructure. https://hitinfrastructure.com/news/lack-of-broadband-access-can-hinder-rural-telehealth-programs
Pete, J. S. (2020, December 8). Jasper County REMC rolling out new broadband service. The Times of Northwest Indiana. https://www.nwitimes.com/business/local/jasper-county-remc-rolling-out-new-broadband-service/article_cdf415a5-4589-508d-a1f4-90a9bfb313e9.html?utm_medium=social&utm_source=email&utm_campaign=user-share
Prior, C. (2014, August). Rural Indiana: A demographic and economic overview. Indiana State University Rural-Urban Entrepreneurship Development Institute. https://www2.indstate.edu/news/pdf/2014-08_IN%20Rural_Counties_Economic_Overview.pdf
Probst, J. (2020, November 17). Social determinants of health: Challenges and opportunities in rural America. Rural and Minority Health Research Center Gateway Webinar. https://www.ruralhealthresearch.org/webinars/sdoh-in-rural-populations
Resnick, B. (2020). How the pandemic forced mental health care to change for the better. Vox. https://www.vox.com/science-and-health/21427156/what-is-teletherapy-mental-health-online-pandemic
Rural Health Information Hub. (2021). Home. https://www.ruralhealthinfo.org/
Sallet, J. (2020, October). Broadband for America now. Benton Institute for Broadband & Society. https://www.benton.org/publications/broadband-america-now
Sanders, C. K., & Scanlon, E. (2021). The digital divide is a human rights issue: Advancing social inclusion through social work advocacy. Journal of Human Rights and Social Work, Online, 1-14. https://doi.org/10.1007/s41134-020-00147-9
Schopp, L. H., Demiris, G., & Glueckauf, R. L. (2006). Rural backwaters or front-runners? Rural telehealth in the vanguard of psychology practice. Professional Psychology: Research and Practice, 37(2), 165-173. https://doi.org/10.1037/0735-7028.37.2.165
Sklar, M., Reeder, K., Carandang, K., Ehrhart, M. G., & Aarons, G. A. (2020). An observational study of the impact of COVID-19 and the transition to telehealth on community mental health center providers. Research Square, Preprint, 1-14. https://doi.org/10.21203/rs.3.rs-48767/v1
Stewart, E. (2020). Give everybody the internet. Vox. https://www.vox.com/recode/2020/9/10/21426810/internet-access-covid-19-chattanooga-municipal-broadband-fcc
The White House. (2021, March 31). FACT SHEET: The American jobs plan. https://www.whitehouse.gov/briefing-room/statements-releases/2021/03/31/fact-sheet-the-american-jobs-plan/
United States Department of Agriculture. (n.d.). Telecommunications infrastructure loans & loan guarantees. https://www.rd.usda.gov/programs-services/telecommunications-infrastructure-loans-loan-guarantees
United States Department of Health and Human Services [USDHH]. (2020a, August). Memorandum of understanding for planning a rural telehealth initiative among the U.S. Department of Health and Human Services and U.S. Department of Agriculture and the Federal Communications Commission. https://www.hhs.gov/sites/default/files/rural-telehealth-mou-hhs-usda-fcc.pdf
USDHH. (2020b, March). Notification of enforcement discretion for telehealth remote communications during the COVID-19 nationwide public health emergency. Office for Civil Rights. https://www.hhs.gov/hipaa/for-professionals/special-topics/emergency-preparedness/notification-enforcement-discretion-telehealth/index.html
USDHH. (2020c, October). Regional Telehealth Resource Center Program notice of funding opportunity. Health Resources and Services Administration, Federal Office of Rural Health Policy, Office for the Advancement of Telehealth. https://www.hrsa.gov/grants/find-funding/hrsa-21-022
Upper Midwest Telehealth Resource Center. (2020, June). Indiana telehealth reimbursement summary. https://www.umtrc.org/clientuploads/Reimbursement/UMTRC_IN_Reimbursement_0612020.pdf
US Ignite. (2020, October 5). US Ignite launches Project OVERCOME funded by the National Science Foundation to accelerate novel broadband deployments in underserved communities. https://www.prnewswire.com/news-releases/us-ignite-launches-project-overcome-funded-by-the-national-science-foundation-to-accelerate-novel-broadband-deployments-in-underserved-communities-301145289.html
Washington Post Live. (2020, September 30). Rep. Donna Shalala says Rep. John Lewis called internet access a civil rights issue. https://www.washingtonpost.com/video/washington- post-live/wplive/rep-donna-shalala-says-rep-john-lewis-called-internet-access-a-civil- rights-issue/2020/09/30/30f8dbb2-a97f-424e-880e-b27f23554df6_video.html
