Opioid abuse and overdose is a national public health crisis, but rural areas face unique challenges. A 2017 study from the Centers for Disease Control and Prevention (CDC) found that while illicit drug use disorders are starting to decline, the rate of overdose deaths in rural areas is increasing and remains higher than the rate in urban areas.

To address these concerns, physicians require better continuity of information between inpatient and outpatient care settings, availability of prescription and behavioral health history, and evidence-based guidance at the point of care. Compounding the challenges of accessing these fundamental data capabilities is more difficult access to care for patients in rural environments.

In order to establish expanded access to care, healthcare organizations should look at how they make themselves available to patients. Telehealth can be one tool to help overcome these requirements by providing clinicians with ready access to the patient’s information. Telehealth helps increase access to care for patients in rural areas who live far away from a clinic or hospital.

Several factors have influenced the rise of opioid overdose in rural communities, including barriers to treatment that include:

• Limited access to substance abuse specialists – Despite the fact that more than 20 million Americans have substance use disorder, less than one in five receive treatment, in part because of lack of providers, especially in rural areas. The problem is compounded in these communities by long travel distances and transportation barriers.
• Stigma and lack of privacy in small communities – Opioid misuse and abuse still carry a stigma. Patients in smaller communities may feel that they cannot seek these services anonymously, which might deter them from pursuing substance abuse treatment.

In addressing the challenges of rural care delivery, many people look to telehealth, which can efficiently address both access and privacy issues. However, according to research from the Blavatnik Institute at Harvard Medical School, just 0.1% of all substance use disorder visits are telehealth visits. The authors of the study call telehealth “a missed opportunity” for treating substance use disorder.

Is telehealth the answer?

Providers have been slow to embrace telehealth in this area for many reasons, perhaps first and foremost because of reimbursement models. In good news, the 2019 Physician Fee Schedule final rule expands the list of Medicare reimbursable telehealth services, and physicians can now receive payment for certain “virtual check-ins” by phone or other technology.

Further, the SUPPORT for Patients and Communities Act passed in 2018 included provisions that enable patients to participate in telehealth visits from home, instead of being required to go to a qualifying center for substance abuse treatment. Other legislation has been introduced to address substance abuse treatment in rural communities, including The Federal Opioid Response Fairness Act and Addiction Recovery for Rural Communities Act.

Efforts to ease restrictions, coupled with growing interest from consumers, will increase the use of telehealth and expand access to treatment, especially in rural communities. As the fight against opioid misuse, abuse and overdose continues, we must use telehealth and other technologies to deliver smarter healthcare.

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