For some rural Texans, the closest link to a doctor may now be the local library. Across the state, libraries are helping residents, particularly older adults, access telehealth appointments and digital health tools in communities where clinics, broadband, and transportation remain limited.
Telehealth has emerged as a key tool for improving health care access for older adults in rural communities, where long travel distances, physician shortages and higher rates of chronic illness are common.
However, broadband access, technology barriers, and shifting telehealth policies continue to limit how widely older people in rural areas can use these services.
“The most expensive part of any broadband development is the last mile. You can get broadband to a rural library, medical clinic, or hospital, but what about the person who lives a mile and a half out of town? That’s the most expensive piece of broadband expansion, that last-mile access,” said Brock Slabach, chief operations officer at the National Rural Health Association (NRHA). “So you’re going to have people, especially in rural areas, including elderly residents, who unfortunately won’t be able to access broadband or telehealth because they don’t have that connection right now.”
Rural libraries in Texas are stepping in as digital access points for telehealth appointments and local health care support.
The Dublin Public Library, in Erath County, used grant funding to distribute internet-enabled devices to more than 50 residents through a Digital Navigator program, relying on partnerships with local organizations to identify community members most in need of technology and connectivity.
This effort was part of a broader state initiative aimed at helping libraries bridge the digital divide by providing devices, connectivity support, and digital skills assistance to underserved residents.
“Access to reliable broadband remains a significant challenge in Erath County, particularly for residents in more rural areas. The library plays a critical role in helping bridge that digital divide by serving as a free, trusted access point for both technology and connectivity,” said Adina Dunn, the library director at Dublin Public Library. “For many of our patrons—especially older adults—the digital world can feel overwhelming or even inaccessible at first…From expanding telehealth access to strengthening digital literacy programs, we are committed to making sure that no one is left behind as more essential services move online.”
Dunn said the library plans to expand its role in supporting telehealth by participating in the Texas State Libraries and Archives Commission grant program to create a dedicated telehealth space with privacy and reliable internet access.
“In the meantime, we already assist patrons with a wide range of healthcare-related technology needs. The most common requests include helping individuals set up and access email accounts, log into patient portals, complete online medical forms, and join video appointments,” Dunn said. “For many, even small barriers—like remembering passwords or navigating unfamiliar websites—can prevent them from getting the care they need.”
Some rural libraries have already developed and implemented telehealth hubs on-site.
In 2024, the American Heart Association partnered with rural West Texas libraries, beginning in Jeff Davis County (Jeff Davis County Public Library) and expanding to Reeves County (Reeves County Library) and Hockley County (Sundown Public Library), to launch virtual health hubs. These libraries were equipped with private telehealth rooms, blood pressure monitors, pulse oximeters, and weight scales for self-checks during virtual medical visits.
The initiative also made CPR training kits, tabletop blood pressure machines, and take-home monitoring cuffs available to library patrons, aiming to address local high hypertension rates—31% in Jeff Davis County, 33% in Reeves County and 33% in Hockley County—as well as limited access to healthcare providers in these rural communities.
“We wanted to build a space that was somewhere that’s quiet, it’s comfortable, it’s a place that the community already trusts and is already utilizing, such as a county or city public library,” said Kassandra Hunt, a registered nurse and the senior director of community impact at the American Heart Association. “We wanted to make it a comprehensive space where people could access health care by utilizing telehealth.”
Kassandra Hunt uses a tabletop automated blood pressure monitor at Sundown Public Library in Hockley County, Texas. (Photo by Dakota Guevara/American Heart Association)
Hunt said this model specifically accounted for older populations in rural Texas.
“We know that older residents can’t always travel easily, some people are homebound or rely on others for a ride. In some cases they may still have to drive to the library, but that’s often much more feasible than driving an hour or two to the nearest health care provider,” Hunt said. “With library staff also able to help with the technology, we’re trying to make it accessible for everyone, regardless of age.”
For the town of Sundown, in Hockley County, expanding health care resources has been top of mind for the past decade. In 2016, the town cut all EMS services due to budget issues, increasing wait times for first responders by about 15 minutes. The library has stepped in to help fill that gap.
“We’ve tried to be diligent about teaching hands-only CPR to community members, because it can potentially save lives,” said A’ndrea McAdams, the library director at Sundown Library. She recalled a case where a man in his mid-40s suffered a cardiac arrest, and his wife—trained through her school—was able to perform CPR until EMS arrived.
The telehealth hub at the Sundown Public Library in Hockley County, Texas. (Photos courtesy of Sundown Library)
Although internet access in Sundown is generally high, many older residents remain unfamiliar with digital technology, creating barriers to telehealth and other online services. Library staff have worked to bridge this gap, helping patrons understand how to connect with doctors via phone or computer, navigate patient portals, and access virtual medical appointments, which can save both time and travel costs.
“Especially in rural communities, you just look after each other. For healthcare, just taking the time to sit and have discussions with patrons and be available, even though it’s a time commitment, can help them feel more comfortable using technology. That’s our goal,” McAdams said.
That approach is already showing results.
“Our telehealth usage has increased 60% from last year, so we’re reaching more people, but it’s really about moving beyond the idea that the library is just for books. We actually have a library of things,” McAdams said.
The library’s stationary tabletop blood pressure kiosk has been used more than 300 times over a 15-month period, and a trained community health worker has partnered with the library to further support patrons.
In Jeff Davis County, where the median age is 58, the Jeff Davis County Library’s telehealth and partnership with the American Heart Association is helping residents age in place, staying at home and remaining independent as they grow older.
The telehealth hub at the Jeff Davis County Public Library. (Photo courtesy of Jeff Davis County Public Library)
“We have a lot of people who are aging in place here, and so anything that can help them access doctors and specialists and not have to leave their home or not have to tax their limited income is really useful,” said Erin Ray, the library director of the Jeff Davis County Public Library. “I’ve been so impressed with all of the various entities that have leaned in to kind of provide that support and help bridge those gaps.”
The library’s telehealth services are part of a broader effort to address the challenges of rural health care, where long distances, limited transportation, and physician shortages make access difficult for older adults. Aside from the telehealth clinic at The Davis Mountain Clinic, the nearest hospitals and patient centers are in Alpine, a 30-minute drive away.
“There really is a huge sort of gap in services and in rural areas,” Ray said. “For a lot of our residents, even driving to Alpine for medical care can be difficult—either because they’re elderly and may not be able to drive, or because their socioeconomic status makes it hard to afford the trip. Because of that, the need for some kind of medical attention locally is pretty great. That’s where the library stepped in.”
Medical monitoring equipment in the telehealth hub at the Jeff Davis County Public Library. (Photos courtesy of the Jeff Davis County Public Library)
By providing private telehealth rooms, medical monitoring equipment, and guidance from staff, libraries are stepping into a role once reserved for clinics, helping residents manage chronic conditions and stay connected to care without leaving their communities.
In the Rio Grande Valley, the Hector P. Garcia Public Library in Mercedes is taking a similar approach, but with an added focus on bilingual services. Spanish-language courses and digital literacy programs help older adults and Spanish-speaking residents navigate everything from online job applications to telehealth portals.
One of the library’s digital navigators, Tristan Garza, said older patrons often struggle with technology and mistrust online information, making in-person guidance essential.
“Patrons can call the library or visit in person to get a second opinion or verified information from reputable sources,” Garza said, highlighting the library’s role in bridging both language and digital literacy gaps.
For many rural libraries in Texas, evolving to meet health care needs is part of their mission. “Many of our older patrons come to the library not just for internet access, but to stay connected—to their families, their community, and essential services,” Dunn said. “Ultimately, the library is more than a place—it’s a partner. We’re here to help people stay connected, informed, and supported, no matter where they’re starting from.”
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.
The post Part 2: Hands-On Telehealth Helps Reach Rural Texas Communities appeared first on The Daily Yonder.
