This technology usually requires broadband and a computing device. More than four million rural homes have no access to the Internet, and a million other homes with broadband still may not have sufficient power. However, Internet access alone doesn't ensure a successful experience.

"Furthermore, what happens if there isn't technical support when someone has a problem with a telehealth app?" asked Peter Caplan, managing consultant for New York-based eHealth Systems & Solutions. "Who's training patients what to do if the Internet has a glitch? During COVID, many doctors didn't fully understand how to properly do a virtual medical consultation."

Telehealth vendors have done a good job of making sure their software doesn't take up too much bandwidth and that it is user-friendly. For doctors and patients, the software is the relatively easy part. The two biggest challenges are telehealth adoption and health literacy. In 2015, the National Digital Inclusion Alliance defined broadband adoption as daily access to the Internet:

• At speeds, quality and capacity necessary to accomplish common tasks;
• With the digital skills necessary to fully participate online; and
• On a personal device and secure, convenient network.

Several federal agencies are increasing funding for building affordable broadband networks, and the FCC offers a $3.2 billion Emergency Broadband Benefit. Both could help establish and expand telehealth. The benefit offers homes a $100 discount on computers and smartphones, plus a monthly $50 subsidy for Internet service, or $75 for tribal homes. More than one million people already have enrolled.

Digital navigators are working with the public to close the gap.

"Digital navigators meet with clients to assess their technology and baseline digital skills, and follow up to make sure they meet their goals." said Shauna Edson, digital inclusion coordinator for the Salt Lake City Public Library. "They advise patrons how to use technology to fully participate in their communities, the economy and society. We have three part-time navigators work in the library and three full-time navigators work in our community-based organization partners."

Edson and the library are working with the alliance and Local Initiatives Support Organization to create a model that can be replicated by libraries and community organizations nationwide. "We're working on creating all the documents to help support this type of model in other organizations," Edson said. "I believe there are some organizations focusing on this model just for telehealth support."

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