The University of Virginia Telemedicine Program: traversing barriers beyond geography.

Access to specialty healthcare remains inadequate for many of our rural citizens, a situation attributable to a host of factors ranging from geographic to economic barriers, worsened by the limited numbers of specialists who practice in rural communities. We wish to report our progress in the development of a robust 55-site telehealth network in the Commonwealth of Virginia, designed specifically to enhance access to specialty care not locally available in rural regions of the state. We will review the process by which we developed partnerships with otherwise unaffiliated healthcare facilities, the equipment and telecommunications services used, and the statutory, regulatory, and cultural impediments to the fullest deployment of telehealth facilitated healthcare and education. Through this network, early and timely intervention has saved lives, avoided unnecessary transfer and travel, and initiated previously unavailable screening and education programs in many rural communities.