When patients in Colorado’s remote Yampa Valley needed to see a specialist, the trip often meant a daylong journey to Denver: hours on the road, time off work, child care arrangements and the cost of gas. Now, they can log in for a virtual visit with a neurologist, maternal-fetal medicine expert or psychiatrist — all without leaving town.

“It not only saves the patient time and money,” Laura Sehnert, MD, chief medical officer at UCHealth Yampa Valley Medical Center in Steamboat Springs, told Becker’s. “It often makes them more willing to receive the care.”

From Wyoming to Colorado, Minnesota to Michigan, rural hospitals are quietly building a new model for access — one that uses technology not to replace care, but to bring care closer to home, closing long-standing gaps in access. From broadband expansion and digital literacy programs to virtual specialty networks and AI-enabled care, their efforts offer a glimpse of what digital equity in rural health care could look like over the next decade.

For many hospitals, that work begins not with new technologies, but with basic infrastructure and human connection. At MyMichigan Medical Center Alpena, located in the state’s sparsely populated northeast region, limited broadband remains one of the most persistent barriers. Some areas even lack cell service. For others, satellite broadband is technically available but prohibitively expensive.

“The cost of broadband goes up as the areas are more remote,” Pankaj Jandwani, MD, CIO for MyMichigan Health, told Becker’s. “And the tools and equipment that are necessary are not affordable either — even for our own services.”

The hospital has also found that digital literacy varies widely by age, culture and comfort level, requiring tailored approaches. “Some patients may want to text, some prefer video, some want a touchless experience, others want to see their provider in person,” Hunter Nostrant, president of MyMichigan Medical Center Alpena, told Becker’s. “We have to serve a wide range of demographics.”

Other hospitals are turning to community-based strategies to bridge similar gaps. Evanston (Wyo.) Regional Hospital is relaunching an affinity program for adults over 50 to help them learn how to use digital health tools. “Enhancing digital health literacy enables individuals to utilize available digital tools,” the hospital wrote in a statement.

Trust is another foundational challenge. Alpena leaders say it’s crucial to build confidence in the security of patient data — especially among older populations. “There’s a lot of skepticism around whether these technologies are secure,” Mr. Nostrant said. “We have to keep promoting the message that they are, and strengthen our cybersecurity efforts to back that up.”

Once the foundation is in place, hospitals are turning to virtual care as one of the most effective tools for closing rural access gaps. Yampa Valley offers an expansive menu of virtual services, from telestroke and telepsychiatry to virtual hospitalists, intensive outpatient behavioral therapy and pediatric subspecialties through Aurora, Colo.-based Children’s Hospital Colorado. Ryan Larson, director of clinic operations at UCHealth Yampa Valley Medical Center, said all specialties are capable of providing telehealth. Providers use clinical judgment to decide when it’s appropriate, blending virtual and in-person care.

UCHealth’s Virtual Health Center supplements that local capacity, adding a “layered” approach to care: a bedside team supported by remote specialists monitoring patients in real time. Dr. Sehnert said the pandemic opened “so many doors in this arena,” and she expects more remote monitoring and AI integration to expand access even further.

Evanston Regional Hospital has adopted a similar model in its emergency department through an affiliation with the University of Utah in Salt Lake city. TeleStroke, TeleBurn and TeleCritical Care programs allow specialists to consult directly with patients and doctors without requiring transfers — a major relief for families in remote areas.

In central Minnesota, HealthPartners’ Olivia Hospital & Clinic — representing some of the system’s most rural communities — relies on primary care virtualist programs to give patients same-day access to clinicians and avoid unnecessary ER visits. E-consults and video visits help patients bypass hours of travel for specialty opinions, making routine care more accessible.The system has also expanded its “my dashboard” personalized digital experience to all patients, including those in rural Minnesota and Wisconsin.

“By giving every patient a personalized digital experience, we’re empowering them to take charge of their health, and we’re delivering more proactive, connected and efficient care,” Jen Macik, MSN, RN, chief nursing officer for Olivia, told Becker’s.

Some hospitals are layering these approaches into broader strategies that extend beyond their walls. MyMichigan Alpena uses social determinants of health screenings at intake to identify transportation, medication and caregiver needs. Those insights guide partnerships with federally qualified health centers and local nonprofits, which help provide transportation and other support.

“It’s not just about MyMichigan,” Mr. Nostrant said. “We coordinate extensively with community partners to ensure not only our patients, but the patients of the whole community, are served.”

And at Yampa Valley, leaders describe a feedback loop between patients, clinicians and informatics teams. “Our local providers constantly listen to patients, and that feedback is shared with leadership to identify what other conditions can be supported virtually,” Mr. Larson said. Oncology and pain management are recent examples of services expanded, based on patient input.

Looking five to 10 years ahead, many leaders expect AI and regulatory clarity to be decisive factors. Dr. Jandwani believes AI will lower digital literacy barriers by making technology more intuitive, similar to the iPhone’s impact. Ambient AI tools are already being piloted to reduce clinician administrative burden, freeing up time for patient care. Mr. Larson expects AI and remote monitoring to make more patients “eligible” for virtual care by integrating data from home devices.

But technology alone won’t overcome structural barriers. Mr. Larson pointed to the annual uncertainty around telehealth reimbursement as a destabilizing factor. “Every 12 months, providers ask, ‘Can we continue with virtual?’ Patients feel the uncertainty, too. Rather than extending reimbursements, the conversation needs to be around making them permanent.”

Mr. Nostrant emphasized the importance of advocacy and funding to support infrastructure in remote regions, and that “the ability to leverage grants or programs to enhance technology and infrastructure is going to be imperative.”

For rural hospitals, digital equity isn’t a single program or technology — it’s a layered strategy that combines infrastructure, literacy, virtual care, partnerships and policy advocacy.

“We must keep the main thing the main thing,” Dr. Jandwani said. “Digital technologies are just offerings. We have to support them with our workforce and operations, focus on patients and their needs, and leverage every partnership we can.”

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