Telehealth may help ameliorate rural healthcare shortages and related negative health outcomes for rural populations in the United States. However, telehealth utilization has been lower among rural than urban populations. Patient experiences are an essential determinant of healthcare utilization and effectiveness. To inform efforts to address disparities in telehealth utilization, we sought a situated, contextual understanding of patient experiences with telehealth among rural-dwelling adults in California. We used Interpretive Phenomenology qualitative methods. In-depth semi-structured interviews explored rural life contexts, rural healthcare experiences, and valuations of telehealth among 16 rural-dwelling adults who used telehealth at a distant urban medical center. Themes of scarcity and fragmented care characterized participants' rural healthcare experiences. Participants placed high value on their rural settings, despite limitations imposed by rural living. Informed by these contexts, participants offered highly positive assessments of telehealth and its utility for rural patients. Telehealth emerged as a positive tool for participants to support healthcare access and a rural way of life. However, findings point to a need to explore whether telehealth may contribute to rural healthcare bypass behaviors. Ongoing research is also needed to understand the telehealth experiences and preferences of underserved and minoritized rural populations.
