Telemedicine utilization by North Carolina farmworkers: a content analysis

Farmworkers face a variety of barriers to accessing health care. Telehealth, often proposed as a solution to access issues, has yet to be widely adopted by this population due to a lack of broadband access amidst other barriers. Policies surrounding funding for broadband and telehealth reimbursement exacerbate the issue. An examination of public use data shows that farmworkers have a great need for mental health and chronic disease services, and that telehealth may be a useful intervention for both. Pre-existing programs in North Carolina such as the Internet Connectivity Project and TeleFuturo contribute to increasing access. Lessons from these programs show that a variety of public and private funding sources are needed to ensure access to telemedicine for North Carolina farmworkers. It is recommended that policymakers (a) develop incentives for nongovernmental entities to partake in the expansion of broadband connectivity and telehealth programs, (b) require health insurance companies to provide reimbursement parity for all appointment modalities, and (c) require future migrant housing to have internet access. There is also a need to increase the availability of Spanish-language telehealth services.