Vulnerable, US-based providers practicing in the digital divide suffer from isolation, lack of professional collaboration in particular with specialty services, frustration with lower connectivity, infrastructure challenges, and low reimbursement when they provide telehealth services (Shulver et. al, 2016; Perzynski et. al, 2017). While, initially, rural providers experience telehealth as a risk for quality and safety, and as a distraction from their clinical mission, the challenges of rural practice lead them to an awareness of the necessity and benefits of telehealth (Shulver et. al, 2016). In their analysis of 44 clinicians’ perceptions of telehealth, Shulver et. al (2016) show that rural providers perceive a need to retrain and deeply change the way they deliver care.
Subedi, Peterson, and Kyriazakos (2011) found that providers of rural and remote locations who receive training and encouragement for telemedicine will influence a patient’s health status. Focusing on asynchronous communication and Remote Patient Monitoring (RPM) will allow rural areas to access Telehealth services (Subedi et. al, 2011).