Date of Defense

12-9-2025

Date of Graduation

12-2025

Department

Biological Sciences

First Advisor

Kieran Fogarty

Second Advisor

Rob Lyerla

Abstract

Telemedicine has emerged as one of the most transformative innovations in modern healthcare, offering new opportunities to bridge long-standing gaps in access, quality, and continuity of care. Rural and underserved communities in the United States face persistent barriers to healthcare, including provider shortages, geographic isolation, limited access to specialty services, transportation challenges, and socioeconomic disparities. These structural barriers often delay diagnosis, disrupt chronic disease management, and worsen overall health outcomes. Telemedicine provides a mechanism to address many of these obstacles by enabling remote consultations, real-time monitoring, follow-up appointments, and access to specialty providers through digital platforms.

This thesis examines the effectiveness of telemedicine as a crucial tool for expanding healthcare accessibility and enhancing patient outcomes. A systematic literature review of research published between 2018 and 2025 was conducted to synthesize evidence across clinical, technological, behavioral, and policy domains. The analysis integrates the Technological Acceptance Model (TAM) and Andersen’s Behavioral Model to interpret how perceptions, digital literacy, enabling resources, and population needs influence telemedicine utilization. These models provide structure for understanding not only why telemedicine is effective but also why its benefits are unevenly distributed.

Across studies, telemedicine consistently demonstrates clinical effectiveness comparable to traditional in-person care for chronic illness management, behavioral health, postoperative monitoring, and preventive services. Patients frequently report high satisfaction with virtual visits due to reduced travel burden, greater scheduling flexibility, lower costs, and increased comfort. Remote monitoring and virtual follow-up have been shown to improve adherence, reduce complications, and enhance early detection of worsening chronic conditions.

Despite these benefits, significant barriers remain. Limited broadband access, lack of compatible devices, variations in digital literacy, and inconsistent reimbursement and licensure policies hinder the adoption of equitable telemedicine. Ethical considerations, including privacy, data security, and accessibility, underscore the importance of careful implementation.

The research indicated that telemedicine is most effective when integrated into hybrid care models that preserve the option for in-person evaluation and assessment. Strengthening technological infrastructure, expanding digital education, improving user-centered design, and establishing stable, long-term policies will be critical to ensuring that telemedicine reduces, rather than reinforces, inequities in healthcare. As digital health innovations continue to advance, telemedicine holds substantial potential to improve accessibility, continuity, and quality of care for populations historically marginalized by the healthcare system.

Access Setting

Honors Thesis-Open Access

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