{"id":231624,"date":"2026-04-02T10:11:13","date_gmt":"2026-04-02T10:11:13","guid":{"rendered":"https:\/\/www.newsbeep.com\/us-tx\/231624\/"},"modified":"2026-04-02T10:11:13","modified_gmt":"2026-04-02T10:11:13","slug":"hands-on-telehealth-helps-reach-rural-texas-communities","status":"publish","type":"post","link":"https:\/\/www.newsbeep.com\/us-tx\/231624\/","title":{"rendered":"Hands-on telehealth helps reach rural Texas communities"},"content":{"rendered":"

Subscribe to The Y\u2019all<\/a> \u2014 a weekly dispatch about the people, places and policies defining Texas, produced by Texas Tribune journalists living in communities across the state.<\/p>\n

A shipping container<\/a> in Fort Davis is at the center of a new experiment in bringing telehealth to an aging rural population.<\/p>\n

Perched in the Davis Mountains of West Texas, Jeff Davis County faces steep barriers to care. Nearly one in five residents lacks reliable broadband. The only doctor in Fort Davis, the county seat, is semi-retired, and most people make the 30-minute drive to Alpine for care. With a median age<\/a> of 58, among the highest in the country, the need for consistent medical care is growing, even as access, both in-person and virtually, remains a challenge.\u00a0<\/p>\n

The retrofitted 40-foot container houses the new Davis Mountain Clinic in Fort Davis, a telehealth hub created through a partnership between Texas A&M and Texas Tech<\/a> universities to connect residents with remote medical and mental health professionals.<\/p>\n

But for rural Texas, expanding telehealth for aging populations depends on more than video calls. It requires reliable broadband, digital literacy for older residents, trusted community health workers, and practical ways for clinicians to weave virtual visits into everyday care.<\/p>\n

Since opening in October 2025, the Davis Mountain Clinic has added something many rural telehealth programs lack: a physical place with reliable connectivity and a local registered nurse, Carol Brewer, who can take vital signs, perform physical exams, and guide patients through virtual visits with providers who may be hundreds of miles away.\u00a0<\/p>\n

Brewer, who is also the director of the clinic, said this approach creates a whole new world of access for the community, especially for older patients who may feel less comfortable navigating virtual appointments.\u00a0<\/p>\n

\u201cThe majority of the patients I see are part of an older population,\u201d Brewer said. \u201cThe advantage is, when they come here to see the doctor, I manage the technology on my end, they don\u2019t have to deal with that at all\u2026I\u2019m the hands of the physician via telehealth. I have a stethoscope and an otoscope. So they can hear their lung sounds, heart sounds, bowel sounds, or look in their eyes, ears, nose. I facilitate that.\u201d<\/p>\n

\"\"<\/p>\n

Inside the Davis Mountain Clinic, an exam room allows patients to be seen by virtual physicians and specialists with in-person support from a registered nurse. (Photo by Carol Brewer)<\/p>\n

Brewer\u2019s hands-on approach highlights how telehealth can be tailored to the realities of an older, rural population, where technology alone isn\u2019t enough, and personal guidance can make the difference between care received and care missed.<\/p>\n

\u201cPeople who live in rural areas are older, sicker, and poorer than people who live in urban areas. Because of that, there are absolutely practical applications for telehealth and its clinical applications,\u201d said Billy U. Philips, PhD, the former executive vice president of the The F. Marie Hall Institute for Rural and Community Health<\/a> and current Grover E. Murray Professor at Texas Tech University. \u201cBut when you overlay with age dimension, then the delivery of care is really going to depend on local and personal circumstances.\u201d\u00a0<\/p>\n

Brewer sees the importance of local connection and community in her work every day.\u00a0<\/p>\n

\u201cI had a patient that came and saw the doctor [virtually] yesterday. His wife had dropped him off, and I gave him a ride home afterwards, because his wife had to go down to Alpine,\u201d Brewer said. \u201cThere are just things that we can do for the patients that they\u2019re not going to get anywhere else.\u201d<\/p>\n

Brewer said that even though the county has just 1,200 residents, she often sees several patients each day. Some come for virtual appointments, while others need help managing aging-related care, navigating insurance, or even obtaining copies of their medical records.<\/p>\n

\u201cI had a patient whose daughter came by and said she didn\u2019t think her mom looked well, and her vehicle was out of commission, so she couldn\u2019t get her to the doctor. I went to their home and checked on her mom, and sure enough, her oxygen levels were low and she wasn\u2019t wearing her oxygen,\u201d Brewer said. \u201cWe got her back on [the oxygen] and stabilized her, and while I was there, I called to set up a doctor\u2019s appointment. The daughter was arranging another way to get her mom to the doctor. It\u2019s a small community, so if they can\u2019t come to me, I go to them.\u201d<\/p>\n

This hybrid delivery of care offers hands-on support while also connecting a rural community to specialists and providers in different corners of the state.\u00a0<\/p>\n

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The Davis Mountain Clinic has a designated room for mental health consultations and appointments. (Photo by Carol Brewer)<\/p>\n

Technology challenges<\/p>\n

A 2025 report<\/a> from the Texas Broadband Development Office found that Jeff Davis County faces significant broadband challenges due to its small, aging population, mountainous terrain, and high proportion of residents with disabilities or limited English proficiency. These factors make deploying reliable, affordable internet costly and complex, often requiring public subsidies to make broadband expansion feasible.\u00a0<\/p>\n

But these hurdles aren\u2019t unique to Jeff Davis County.\u00a0<\/p>\n

In rural parts of Texas\u2019s Coastal Bend, along the Texas Gulf Coast, available broadband is not equivalent to reliable broadband.\u00a0<\/p>\n

\u201cEven if you pay for the platinum packages, you may at best receive only so-so service,\u201d said Amy Kiddy Villarreal, director of the Coastal Bend Aging and Disability Resource Center<\/a>. \u201cInternet availability and quality are among the biggest hurdles [to accessing telehealth].\u201d\u00a0<\/p>\n

Philips said that across rural Texas, broadband is often limited, unreliable, and costly, creating obstacles for telehealth and other digital services. While commercial expansion may improve access over the next decade, for now some residents rely on shared community spaces, like clinics, senior centers, and libraries, to get online.\u00a0<\/p>\n

These hubs not only provide connectivity but can also offer guidance for older or less tech-savvy residents, helping them navigate the digital tools they need for health care and daily life.<\/p>\n

Highlighting the practical challenges of expanding connectivity, Philips emphasized the need for flexible solutions that give rural residents real choice: \u201cThe question now is: how do we get things done in such a way that rural populations have choice and have competitive pricing, and have places where they can have access, even if it isn\u2019t in their home?\u201d he said.<\/p>\n

This effort is underway in the Coast Bend region.\u00a0<\/p>\n

\u201cCoastal Bend Council of Governments\u2019 new broadband planning effort is working to bring better, faster internet to the parts of the Coastal Bend that need it most and will make telehealth visits more available and dependable for older adults,\u201d Villarreal said. \u201cBy identifying where service is lacking and collaborating with local health care providers and community leaders, this plan lays out the groundwork for more reliable telehealth at home and in trusted community spaces. Together, these improvements help ensure that people in rural areas can access the care they need, when they need it.<\/p>\n

Digital literacy promotes health<\/p>\n

Across rural Texas, distance is more than a matter of miles, it can be the difference between receiving timely care or going without it. In the Permian Basin, a region in southwestern Texas, older adults can travel hours for a routine doctor\u2019s visit. Limited broadband access, few primary care providers, and scarce public transportation create steep barriers.<\/p>\n

Alma Montes, director of Area Agency on Aging of the Permian Basin<\/a>, is tackling these issues head-on with a commitment to helping older people in rural Texas age in place.<\/p>\n

\u201cIn these rural towns, they really are the best places to age. In all my years doing this work, smaller communities are where you want to be when you\u2019re older. You can drive longer, there\u2019s no traffic, and everything, from your house to the senior center, is just a few blocks away,\u201d Montes said. \u201cYou feel empowered longer. You\u2019re connected to a community where people check in on you, know your routine, and notice if something\u2019s off. It\u2019s just a shame primary care isn\u2019t there for them, because it truly is a great place to grow old.\u201d<\/p>\n

In these Permian Basin communities, social cohesion is strong, but health infrastructure is thin. Residents lean on neighbors and family, yet often have to leave town for basic services. Montes found that older adults\u2019 struggles with telehealth weren\u2019t just about access to broadband or devices.\u00a0<\/p>\n

Through a partnership with Aetna, her team distributed tablets and trained about 50 seniors to use email and access virtual care. The bigger barrier wasn\u2019t connectivity, she said; it was unfamiliarity. Many older residents were wary of technology they haven\u2019t used before, making ongoing support essential for the successful implementation of telehealth.\u00a0<\/p>\n

Montes said that investing in these skills, tools, and community partnerships paid dividends beyond just telehealth access.\u00a0<\/p>\n

\u201cWe want to improve their overall well-being. Even if we didn\u2019t fully get them to telehealth, there were gains along the way. They can now email family, send and receive photos, connect on social media, even Skype with loved ones. And we know, especially after COVID, that social connection has a real impact on health,\u201d Montes said. \u201cSo even if they\u2019re not all doing telehealth visits, they\u2019re using technology in ways that positively affect their health.\u201d<\/p>\n

Community health workers<\/p>\n

In many rural communities, and particularly among immigrant families, concerns about privacy, scams, and surveillance shape how residents engage with new systems. That\u2019s where trusted local resources, like community health workers, become essential.<\/p>\n

Community health workers are trained, certified locals who help residents navigate care, connect to services and access basic health support.<\/p>\n

\u201cOut in these rural communities, part of the [telehealth implementation] has to do with trust and whether you know the person,\u201d Philips said. \u201cSome patients have heritages that make them potential targets for law enforcement operations or other authorities. So you need a trusted figure\u2013a navigator or community health worker\u2013that\u2019s known to that community and trusted. We equip those individuals to serve as a bridge, helping people understand and use the technology available to them.\u201d<\/p>\n

Training programs across rural Texas<\/a> aim to expand the pool of community health workers and equip them both to be a local resource and a facilitator to accessing more expansive care virtually.\u00a0<\/p>\n

Practicing telemedicine<\/p>\n

For Dr. Ariel Santos, a trauma and acute care surgeon and director of the Texas Tech Telemedicine Program, telemedicine allows him to triage patients across rural West Texas, determining when situations demand air ambulances or when a patient can be treated locally.\u00a0<\/p>\n

\u201cAs a trauma surgeon, I\u2019d rather be consulted earlier when there\u2019s a trauma patient,\u201d Dr. Santos said. \u201cTelemedicine can be used to triage patients\u2026It can either expedite treatment, or it can help determine that a patient doesn\u2019t need to be transferred.\u201d<\/p>\n

Dr. Santos said these calls can save tens of thousands of dollars in unnecessary medical transfers and also reduce the number of visits a patient has to make as they receive continuity of care.\u00a0<\/p>\n

\u201cI could use [telemedicine] to pre-op the patient, meaning to prepare them before seeing them in person,\u201d Dr. Santos said. \u201cAnd postoperatively, I could see the patient and check on the wound easily, without them needing to spend time and money traveling.\u201d\u00a0<\/p>\n

Dr. Santos also sees telemedicine\u2019s potential beyond trauma. One key example is Project ECHO<\/a> (Extension for Community Healthcare Outcomes), a virtual collaboration model designed to support rural providers in caring for complex patients.\u00a0<\/p>\n

In rural Texas, caring for older adults with dementia often means working without nearby specialists. The Dementia Care ECHO program uses a hub-and-spoke structure, connecting geriatric experts at a central \u201chub\u201d with local primary care teams, long-term care staff, and community providers, the \u201cspokes,\u201d through virtual sessions. Multidisciplinary teams, including doctors, dietitians, pharmacists, and social workers, guide providers through real patient cases, helping them deliver specialized care that might otherwise be out of reach.<\/p>\n

\u201cThrough the ECHO program, we can leverage geriatricians\u2019 speciality using technology,\u201d Dr. Santos said.\u00a0<\/p>\n

For patients and caregivers, it brings expert support closer to home, though limited broadband continues to challenge access in many communities.<\/p>\n

The future of rural telehealth<\/p>\n

Telehealth offers an alternative pathway for delivering care for both patients and providers. However, experts warned that telehealth should not be seen as a replacement for in-person care, but rather a supplemental service that expands access, especially for rural populations.\u00a0<\/p>\n

\u201cTelehealth is not a substitute for good, high quality primary care,\u201d said Brock Slabach, chief operations officer at the National Rural Health Association (NRHA<\/a>). \u201cSo in my opinion, it should be delivered as a tool for primary care and for specialists to be able to enhance the care continuum and hopefully, in many cases, reduce the need for in-person visits.\u201d\u00a0<\/p>\n

The Davis Mountain Clinic offers one example of balancing telehealth with in-person care delivery.\u00a0<\/p>\n

\u201cI think it\u2019s a great model for other rural communities,\u201d Brewer said. \u201cThe physicians we work with are very supportive. They\u2019re very helpful, and they are also invested beyond just the services that they\u2019re providing. They\u2019re wanting to help in the community, they\u2019re asking for ways that they can serve the community.\u201d\u00a0<\/p>\n

As rural communities continue to innovate in health care, discovering new ways to better serve their patient populations, they also face threats from cuts to broadband<\/a>, health care<\/a>, and education funding<\/a>.\u00a0<\/p>\n

Philips said that without sustained investment, rural communities may struggle to maintain the trajectory of growing telehealth programs and broadband access, putting patients\u2019 health and the progress made in digital care at risk.<\/p>\n

\u201cA lot of these opportunities to adopt and adapt technology were funded by federal resources that are now heavily constrained,\u201d Philips. \u201cAs a country, we have to decide whether we value rural people enough to supply them with the health care and other kinds of essentials, including digital literacy, that will allow us to keep them healthy.\u201d<\/p>\n

Disclosure: Texas A&M University and Texas Tech University have been financial supporters of The Texas Tribune, a nonprofit, nonpartisan news organization that is funded in part by donations from members, foundations and corporate sponsors. Financial supporters play no role in the Tribune\u2019s journalism. Find a complete\u00a0list of them here<\/a>.<\/p>\n

This article was written with the support of a journalism fellowship from The Gerontological Society of America, The Journalists Network on Generations, and The Commonwealth Fund.<\/p>\n

This article<\/a> first appeared on The Daily Yonder<\/a> and is republished here under a Creative Commons Attribution-NoDerivatives 4.0 International License<\/a>. <\/p>\n","protected":false},"excerpt":{"rendered":"Subscribe to The Y\u2019all \u2014 a weekly dispatch about the people, places and policies defining Texas, produced by…\n","protected":false},"author":2,"featured_media":231625,"comment_status":"","ping_status":"","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[6],"tags":[1562,287,27,297,29,293,28,873,6588,375],"class_list":["post-231624","post","type-post","status-publish","format-standard","has-post-thumbnail","category-texas","tag-health-care","tag-politics","tag-texas","tag-texas-am-university","tag-texas-headlines","tag-texas-legislature","tag-texas-news","tag-texas-tech-university","tag-well-c-homepage","tag-west-texas"],"_links":{"self":[{"href":"https:\/\/www.newsbeep.com\/us-tx\/wp-json\/wp\/v2\/posts\/231624","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.newsbeep.com\/us-tx\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.newsbeep.com\/us-tx\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/us-tx\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/us-tx\/wp-json\/wp\/v2\/comments?post=231624"}],"version-history":[{"count":0,"href":"https:\/\/www.newsbeep.com\/us-tx\/wp-json\/wp\/v2\/posts\/231624\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/us-tx\/wp-json\/wp\/v2\/media\/231625"}],"wp:attachment":[{"href":"https:\/\/www.newsbeep.com\/us-tx\/wp-json\/wp\/v2\/media?parent=231624"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.newsbeep.com\/us-tx\/wp-json\/wp\/v2\/categories?post=231624"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.newsbeep.com\/us-tx\/wp-json\/wp\/v2\/tags?post=231624"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}