Telehealth in Oregon 5

higher rates of the five leading causes of deaths in the US, due to lack of resources in ambulatory

settings, limited access to healthcare providers, and fewer transportation options (Batsis,

DiMilia, Seo, Fortuna, Kennedy, Blunt, et al, 2019).

Healthcare Access

Batsis, DiMilia, Seo, Fortuna, Kennedy, Blunt…et al (2019), conducted a systematic

review to assess the feasibility, acceptability, and effectiveness in providing telemedicine

(TMed) to older adults of 65.1 years to 86.45 years. This qualitative study used interventions of

live, synchronous, two-way video-conferencing communication in non-hospital care settings, in

rural areas in the United States from 2012 to 2018, and was conducted according to the Preferred

Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA), using the Cochrane

Collaboration's Risk‐of‐Bias Tool as quality assessment. Of 6,616 citations from electronic

databases, full text of 1,173 articles were reviewed. Of 17 randomized controlled trials, the

United States directed 6 [35%] trials with group sizes ranging from 3–844 (median 35) subjects.

The results from this study concluded that telemedicine (TMed) services may help provide

effective care, particularly in rural and underserved areas in the geriatric population by

improving efficiency, thereby prompting other healthcare facilities in remote areas to promote

telestroke and teleintensive care programs (Batsis, DiMilia, Seo, Fortuna, Kennedy, Blunt,

Brooks, Masutani, Bruce, 2019). In addition, TMed interventions are acceptable and feasible

among geriatrics compared to in-person care, providing better patient experience, accessibility

and reducing the need for transportation to healthcare facilities. The limitation to this study was

that sample sizes of groups consisting of 3 people were small, thus external validity was low,

thereby limiting generalizability, and study content was only available in the English language.

A similar study was conducted by Demiris, Shigaki and Schopp (2005), for needs

assessment of a rural home-based telerehabilitation network to provide better coordination