Telehealth: The Way for Efficient, Comprehensive, and Equitable Antimicrobial Stewardship in the US Healthcare System

Rural and critical access hospitals serve 15% of the United States population and utilize antibiotics at similar rates and spectrum as larger urban hospitals, making them a priority for antimicrobial stewardship. However, barriers such as insufficient personnel, limited electronic health record capabilities, and financial constraints limit stewardship initiatives. Telestewardship partnerships with urban hospitals offer a promising solution; however, a structured process to develop and implement such programs is not established. This perspective focuses on unmet needs in rural hospitals to provide future direction for improved patient care in these settings. In 2024, UW Health engaged leaders of small and rural hospitals to design a telestewardship program that meets regulatory requirements (ie, Joint Commission Standards). Despite these requested services, financial barriers hindered implementation of telestewardship partnerships. This work underscores the opportunities and challenges faced by rural hospitals and the ongoing need for state and national funding to support these communities.