The majority of North Carolinians who are satisfied with their telehealth, or accessing medical care virtually, experiences also have access to high-speed internet, according to a Carolina Public Press survey.

The survey, published Nov. 17, asked North Carolina  residents to rank their telehealth experiences on a scale of 1 to 5 before answering questions about their access to both telehealth and the internet. 

CPP released the survey to expand upon a recent collaboration with the Institute for Nonprofit News  to create Breaking Point, a series about health care barriers for rural Americans. 

Other collaborators in the project, funded by the National Institute for Health Care Management Foundation, included The Daily Yonder, Honolulu Civil Beat and Shasta Scout

CPP focused specifically on the relationship between telehealth uptake and internet access in rural Western North Carolina as both topics gained attention during the COVID-19 pandemic.

More than 60 people across the state responded to the emailed survey, which was available in English and Spanish, in November and December. 

The responses showed mixed opinions about telehealth and the importance of the relationship between stable internet access and the growing reliance on telehealth. 

High-speed internet and telehealth

Of the 36 respondents who gave the highest rankings, 4 and 5, to their telehealth experiences, 21 reported having access to high-speed internet at their homes. Two of the 10 respondents who gave their experiences poor scores, 1 or 2, had high-speed internet. 

“Having high-speed internet makes telehealth an option,” respondent Ben Fike from Hillsborough wrote. “I don’t think I’d try it without that”

Throughout the 18-county region, fewer than 1-in-4  residents has access to broadband fiber, according to the N.C. Department of Information Technology. Broadband fiber is the most reliable form of internet connection because it requires physical infrastructure that is rarely found in rural communities. Other internet sources, such as satellite and cellular data often don’t reach rural communities. 

No fiber access means limited internet connectivity, which often means people like Woody Brinson from Kenansville, a small town in Duplin County, can’t use telehealth due to internet lags that make a continuous conversation difficult.  

Brinson said he would use telehealth more “if better broadband access becomes available.”

Eva R. Duggins, from Mount Gilead in Montgomery County, shared similar thoughts in her survey response. 

“Whether or not I use telehealth depends on whether or not North Carolina ever funds broadband service for rural areas,” Duggins wrote. “I would love to use telehealth, as getting to a good doctor is quite a drive for me, but for right now, I do not have that option.”

In-person or virtual? 

Other respondents said they would not use telehealth because they prefer the human connection associated with an in-person visit.

“I don’t use telehealth because I have medical issues that I feel I need to be seen in person rather than over the internet,” Crystal S. Church, from Caldwell County’s Granite Falls, wrote in her response. “The one time I did use telehealth I ended up in the office in-person anyway with a missed symptom.”

Elaine G. Ruppert of Charlotte wrote: “I’m old. New technology is not user-friendly to older people, especially when we are sick. … Providers appear to be abusing telehealth for revenue, ignoring the limitations of elderly, poor and/or cognitively impaired patients.”

Many respondents shared that telehealth is a practical option and that telehealth made it possible for them to safely access more doctors.

“Telehealth is an additional tool for health care,” wrote Terri Rouse, from Snow Hill in Greene County.  “It doesn’t replace in-person health care, but it does offer another option to get help. If I became incapacitated, I love the fact that I would still be able to get help from my doctors. It is peace of mind for me.” 

The use of telehealth will likely continue to increase — a 2021 American Medical Association survey showed roughly 56% of physicians were looking to increase telehealth use. This means that telehealth is here to stay. Ensuring stable internet access for more North Carolinians to make use of telehealth is as important.

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Shelby Harris a former Carolina Public Press reporter. To reach the Carolina Public Press newsroom, email

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  1. I live in the mountains above Burnsville, NC. I have neither cell phone service nor a reliable internet. Maybe the members of our state house and senate could come together to fix these issues for over 1 million North Carolinians. Where is the spirit of Franklin D. Roosevelt when you need him?