University of Rochester Medical Center

At the height of the COVID-19 pandemic, New York State saw an approximately 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, uneven telehealth use during the pandemic has exacerbated—not reduced—disparities in health care access. Rural residents, people of color, people with low income, people who speak a primary language other than English, and older adults face barriers to telehealth use, including the digital divide, unfamiliarity with digital tools, and privacy and trust concerns. The University of Rochester Medical Center (URMC) has launched an on-demand telehealth service for primary care, but URMC’s rural patients—who stand to gain the most from telehealth—struggle to access it because they lack internet access at home. A regional bank, Five Star Bank, has emerged as a promising, non-traditional site to extend URMC’s reach in rural areas. Only 30% of URMC patients living in rural areas reside within 4 miles of its primary care clinics, yet more than 50% reside within 4 miles of a Five Star Bank branch. There is potential for strong foot traffic in these branches, as rural residents access banking services in person at much higher rates than urban residents. In 2023, NYHealth awarded URMC a grant to pilot a bank-based telehealth model throughout the Finger Lakes, Southern Tier, and Central New York regions in partnership with Five Star Bank, telehealth vendors, and internet providers.  

Under this grant, URMC clinicians will provide virtual services that lend themselves to telehealth: treatment for common problems like urinary tract infections, sore throat, tick bites, and flu, as well as diagnosis, medication prescription, testing, referrals to in-person and emergency care, and screening for health-related social needs. In the first year of the project, URMC and Five Star will pilot telehealth services in up to five branches. Through input from relevant stakeholders, URMC will understand perceptions, barriers, and facilitators of telehealth provided in banks; raise patient and provider awareness; and guide marketing and implementation. In addition, it will conduct education, outreach, and marketing to drive uptake. URMC will operate workgroups with partner organizations to develop and implement clinical protocols, data-sharing, bank renovation, community outreach, and evaluation. Impact will be evaluated by tracking process metrics and patient and bank staff satisfaction to continuously improve pilot implementation.