Improving Access to Care for Vulnerable Missourians: The Hotspot Project

Many rural areas across the country are considered "health and technology desserts." They lack access to healthcare facilities and broadband connectivity for telehealth services. With the emergence of the COVID-19 pandemic and social distancing requirements, rural residents have become even more vulnerable.

To evaluate the utility of distribution of internet hotspots to rural and underserved Missourians for telehealth access.

Mobile wi-fi devices (hotspots) were distributed to Federally Qualified Healthcare Centers and Community Mental Health Centers to be used by clinics and patients for telemedicine visits through the Missouri Telehealth Network project. We analyzed six sets of surveys from clinic administrators, collected between January and June 2021, to assess usage, technical utility of hotspots, and satisfaction with the project.

A total of 163 (71.5%) survey responses were received. Seventy-seven percent (7,981) of the 10,345 ordered hotspots were distributed. Hotspots were used for video visits, with an average of 5,915.66 monthly visits (range: 3,449 - 8,420). Seven facilities reported technical issues. Open-ended survey responses reported overall satisfaction with the project. The project allowed convenient access to telehealth services for both routine and specialty care, while decreasing patient and staff exposure to COVID-19. Hot-spot service enabled patient access to educational opportunities and providers noticed a decrease in no-shows.

The importance of internet connectivity in enabling access and means to care for rural, underserved communities cannot be overemphasized. The hotspot distribution project helped the most vulnerable Missourians access needed care during the public health emergency.