Testing an Innovative Telehealth Model for Primary Care in Rural New York

Grantee Name

University of Rochester Medical Center

Funding Area

Primary Care

Publication Date

March 2025

Grant Amount

$100,000

Grant Date:

June 2023–November 2024

Print

At the height of the COVID-19 pandemic, New York State saw a roughly 130-fold increase in telehealth use. Although telehealth has tapered off, it is here to stay as an option for patients. Telehealth can expand access to care, especially in rural areas with provider shortages. However, the pandemic also underscored that telehealth is not inherently equitable: rural residents, people of color, individuals with low income, people who speak a primary language other than English, and older adults continue to face significant barriers, including lack of internet access, unfamiliarity with digital tools, and concerns around privacy and trust. The University of Rochester Medical Center (URMC) launched an on-demand telehealth service for primary care, but many of its rural patients—those who stand to benefit most—have difficulty accessing it due to limited broadband access at home. Five Star Bank, a regional banking institution, emerged as a promising, nontraditional partner to help bridge that gap. Although only 30% of rural URMC patients live within four miles of a primary care clinic, more than 50% live within four miles of a Five Star Bank branch. Additionally, rural residents are more likely to use in-person banking services than their urban counterparts, offering a unique opportunity to pilot an innovative telehealth model.

In 2023, NYHealth awarded URMC a grant to pilot a bank-based telehealth model across the Finger Lakes and Southern Tier regions, in partnership with Five Star Bank, telehealth vendors, and internet providers. URMC designed this model to offer virtual services well-suited to telehealth, including treatment for common conditions such as urinary tract infections, sore throat, tick bites, and flu. Additional services included diagnosis, medication prescribing, referrals, and screenings for health-related social needs. URMC also worked closely with technology and banking partners to develop clinical protocols, ensure data security, renovate bank space, and conduct evaluations. Preliminary outreach with patients, local providers, and bank staff helped to identify perceptions, barriers, and facilitators for the model and informed implementation and marketing strategies.

Outcomes and Lessons Learned

Developed a first-of-its-kind telehealth kiosk that supports both virtual appointments with an external health system and biometric monitoring (e.g., blood pressure, weight).
Installed kiosks and created private clinical spaces in three bank branches in Bath, Ovid, and Wayland (Seneca and Steuben counties).
Engaged bank customers in 133 unique interactions over six months, including 3 telehealth visits, 72 biometric screenings, and 58 portal-based interactions (e.g., patient registration, health education).
Detected 28 instances of hypertension, including a case of gestational hypertension in a pregnant bank employee who was referred for emergency care to prevent premature birth.

Although the pilot resulted in measurable health benefits, it fell short in terms of broader telehealth use. Despite marketing and outreach, URMC only uncovered deeper community concerns after surveying non-users. Many rural residents expressed skepticism about using banks for medical care, citing privacy, cleanliness, and location as barriers. Some indicated they would be more likely to use the kiosks if recommended by a health care provider. And yet, over 90% of survey respondents were open to community telehealth kiosks. These learnings have informed URMC’s next steps, for instance, in exploring similar kiosks in local YMCAs. These learnings also enabled NYHealth staff to communicate these challenges, and the need for deep patient and community engagement, in public comments to the U.S. Department of Veterans Affairs to inform roll-out of its grant program for telehealth community access points.

Despite challenges, the URMC team has solidified its role as a leader in rural telehealth innovation. Lead researcher Dr. Michael Hasselberg was appointed to the National Academy of Sciences, Engineering, and Medicine’s Standing Committee on Primary Care and invited by U.S. Department of Health and Human Services officials to share strategies for expanding virtual care in rural areas. URMC staff also contributed to NYHealth grantee Manatt Health’s report on equitable telehealth expansion and garnered national media attention for their work.

Co-Funding and Additional Funds Leveraged: Schmidt Futures Fund ($212,346), Greater Rochester Health Foundation ($60,000).

Back to Grant Outcomes