Caswell County, where William Crumpton works, runs along the northern edge of North Carolina and is a rural landscape of mostly former tobacco farms and the occasional fast-food restaurant.
"There are wide areas where cellphone signals are just nonexistent," Crumpton says. "Things like satellite radio are even a challenge."
Crumpton, who grew up in this area, is CEO of Compassion Health, a federally funded community health center. The county has no hospital or emergency room. And for much of the pandemic, about half of the center's patients could only be reached the old fashioned way: a basic voice call on a phone landline.
"We have individuals who live in homes that wouldn't be able to make a cellphone call if they wanted to," he says. "High-speed internet is not available to them; furthermore, the only connection that they had to the outside world in some cases is a rotary dial phone."
So when state and federal governments temporarily eased privacy and security restrictions on telehealth early in the pandemic, many patients across the country were able to get diagnosed and treated by doctors over phones that don't have video or camera functions. That, in turn, made it possible for health care workers to connect with hard-to-reach patients — people who are poor, elderly or live in remote areas.
But today, the rules that temporarily eased licensing and reimbursement restrictions in ways that expanded the use of this type of telehealth service are rapidly shifting.
Here's a New York Times story, published today, on telehealth, but the focus is on video visits.
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