title: Application of a Telecolposcopy Program in Rural Settings.
abstract: Individuals in rural areas are often restricted by the amount of physicians' availability, thus limiting access to healthcare in those settings.
  
  
  
  While Pap smear screening has increased across the United States, the rural South still reports high rates of cervical cancer and mortality. One solution to improve patient outcomes related to cervical cancer in rural settings is telecolposcopy.
  
  
  
  Women with abnormal Pap results or an abnormal visual examination needing an evaluation by colposcopy were referred to a hospital-based telecolposcopy program. Descriptive data are provided that include patients' access to care based on travel time and transportation costs.
  
  
  
  Over a 15-month time period, 940 unique patients were seen using telecolposcopy. Telecolposcopy was done at eight spoke sites across Arkansas representing patients from 72 of the 75 counties. Data for risk factors that include smoking, first sexual experience, and number of sexual partners in past 12 months and in a lifetime are discussed. Pap results and impression are provided. In addition, avoided transportation costs and travel time have been calculated and included.
  
  
  
  Cervical cancer is important public health concern especially for women residing in rural areas. We were able to demonstrate that our telecolposcopy program has provided sustainability statewide since its inception and that patients are willing to participate. In addition to providing increased access to care, the program also reduced travel time and costs associated with a face-to-face visit.
  
  
  
  Telecolposcopy should be further explored and utilized in rural settings as a way to reduce patient costs and improve cervical cancer outcomes.
authors.affiliation: 1 Department of Obstetrics and Gynecology, University of Arkansas for Medical Sciences , Little Rock, Arkansas.
authors.forename: Wilbur C
authors.initials: WC
authors.lastname: Hitt
authors.affiliation: 1 Department of Obstetrics and Gynecology, University of Arkansas for Medical Sciences , Little Rock, Arkansas.
authors.forename: Gordon M
authors.initials: GM
authors.lastname: Low
authors.affiliation: 1 Department of Obstetrics and Gynecology, University of Arkansas for Medical Sciences , Little Rock, Arkansas.
authors.forename: Christian E
authors.initials: CE
authors.lastname: Lynch
authors.affiliation: 2 Department of Biostatistics, University of Arkansas for Medical Sciences , Little Rock, Arkansas.
authors.forename: C Heath
authors.initials: CH
authors.lastname: Gauss
authors.affiliation: 1 Department of Obstetrics and Gynecology, University of Arkansas for Medical Sciences , Little Rock, Arkansas.
authors.forename: Everett F
authors.initials: EF
authors.lastname: Magann
authors.affiliation: 1 Department of Obstetrics and Gynecology, University of Arkansas for Medical Sciences , Little Rock, Arkansas.
authors.forename: Curtis L
authors.initials: CL
authors.lastname: Lowery
authors.affiliation: 1 Department of Obstetrics and Gynecology, University of Arkansas for Medical Sciences , Little Rock, Arkansas.
authors.forename: Hari
authors.initials: H
authors.lastname: Eswaran
mesh_terms: D000293:Adolescent; D000328:Adult; D001131:Arkansas; D003127:Colposcopy / Q000295:instrumentation / Q000379:methods*; D005260:Female; D006297:Health Services Accessibility / Q000458:organization & administration*; D006801:Humans; D008875:Middle Aged; D065006:Papanicolaou Test; D012307:Risk Factors; D019035:Rural Health Services / Q000458:organization & administration*; D012725:Sexual Behavior; D012907:Smoking / Q000453:epidemiology; D012959:Socioeconomic Factors; D017216:Telemedicine / Q000458:organization & administration*; D013997:Time Factors; D014186:Transportation / Q000191:economics; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis*; D055815:Young Adult
keywords: colposcopy; cost avoidance; rural; telehealth; telemedicine