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How did rural telemedicine change in COVID?

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Rural Ontario telemedicine use jumped from about 1.4% of patients in 2012 to 28% in early 2020 as temporary billing codes expanded virtual care.

Source

Rural Telemedicine Use Before and During the COVID-19 Pandemic: Repeated Cross-sectional Study

Chu C, Cram P, Pang A, et al. · Journal of medical Internet research · 2021

doi.org/10.2196/26960Read the full paper ↗116 citationscc by

Study at a glance

Design
Other — Ontario health-administrative descriptive comparison of telemedicine use in 2012, 2016, and early 2020
N
N=1033271 · 2020 rural resident denominator; 290,401 (28.1%) with ≥1 telemedicine visit (vs 14,666/1,017,546 in 2012)
Population
Rural Ontario patients in health-administrative data
Outcome
Prevalence and demographic patterns of telemedicine use

Structured fields used in claim comparison tables when every cited study has a complete layer.

What they did

Using health-administrative data, investigators compared rural patients with ≥1 telemedicine visit in 2012, 2016, and the first half of 2020, describing age, sex, region, income, and chronic-disease patterns as COVID-era fee codes enabled broader virtual visits.

What they found

Rural telemedicine users rose from 14,666 (1.4%) to 290,401 (28.1%). Pre-pandemic use concentrated in Northern Ontario and younger adults; during COVID, use broadened geographically, skewed female, rose with age, and surged in urban as well as rural areas.

The limits

What it doesn't show

Utilization data do not measure clinical quality, equity of outcomes, or whether virtual visits replaced necessary in-person exams safely.

Key terms

Telemedicine
Clinical care delivered remotely, historically often via dedicated videoconferencing networks.
OTN
Ontario Telemedicine Network, a government-funded platform that facilitated two-way video visits.
Temporary fee codes
Pandemic billing codes that reimbursed broader forms of virtual visits beyond the legacy OTN platform.
Repeated cross-sectional study
Comparisons of population snapshots at multiple time points rather than following the same cohort longitudinally.
Rural health access
Challenges such as travel distance and scarce local clinicians that telemedicine aims to mitigate.

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Rural Ontario telemedicine use in early 2020 was about:

Common questions

How large was the COVID-era jump?

Rural patients with any telemedicine visit rose from 1.4% (2012) to 28.1% (2020).

Who used telemedicine most during the pandemic?

Older adults had the highest usage rates; children/adolescents used it least.

What policy change mattered?

Temporary fee codes reimbursing non-OTN virtual visits drove most pandemic telemedicine claims.

Did geography of users change?

Yes—from Northern Ontario predominance to more balanced provincial distribution.

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