Abstract
Americans in rural communities tend to be older and in poorer health than their urban counterparts (NICHM Foundation 2020) and face numerous barriers to health care access, including a paucity of hospitals, clinics, health care clinicians, and transportation options (Douthit et al. 2015). The percentage of the population aged 65 and older is expected to remain disproportionately higher in rural areas for the foreseeable future (Glasgow and Brown 2012). Given the shortage of geriatric specialists in rural areas (Peterson et al. 2011); continual decreases in the rural physician workforce (Skinner et al. 2019); and aging-related barriers to travel because of mobility, vision, and cognitive challenges (Tuttle et al. 2020), rural, older adults could benefit from telemedicine. The Veterans Health Administration (VHA) has long relied on telemedicine to expand accessibility and choice for Veterans and their caregivers enrolled in VA healthcare. In this chapter we describe one VHA telemedicine program, GRECC Connect, that uses a hub-and-spoke model to provide rural patients access to multidisciplinary geriatrics teams in larger urban medical centers