Bridging the healthcare access gap in rural America with remote physical exams 

Healthcare in rural America

Sanford Health, the largest rural healthcare system in the United States, was looking for a virtual care solution that would help them ‌improve access to high-quality, affordable care for their patients.

Residents of rural America can be faced with more determinants than their urban dwelling counterparts, when it comes to accessibility to readily available, affordable healthcare. Some of these determinants can include fewer resources to access care, which can lead to these residents experiencing more instances of chronic disease and poorer health outcomes. Statics show fewer than 10% of America’s physicians are practicing medicine in rural areas.

By improving access to care, Sanford Health is significantly impacting the overall health of the communities they serve.

Virtual care provided healthcare across a geographically dispersed, rural population 

Health plans and providers, recognizing the opportunity that virtual care offers for improving access in underserved areas, have introduced virtual care solutions to bring primary care to people’s homes. Those living in rural communities can find it hard to get medical care, particularly when they are in discomfort due to their illness or injury, as they may need to journey up to 60 miles for treatment. Sanford wanted to extend their reach into rural locations and enable their clinicians to perform more data-driven, robust physical exams for those patients without them needing to travel to hospitals or clinics in urban centers. Expanding on their virtual care offerings would significantly impact members’ experiences of accessing medical care and enable them to receive high-quality treatment more easily.


Improve rural access to care 

Sanford Health sought a virtual care solution that would:
  1. Provide an easy, convenient, and high-quality healthcare experience for their patients and providers.
  2. Account for infrastructure limitations endemic to rural areas.
  3. Serve a vast geographical area regardless of zip code.
  4. Expand their clinicians’ diagnostic capabilities for virtual care patients so that they can receive specialized care without needing to travel long distances.

High-quality virtual care  

Sanford Health partnered with TytoCare to integrate their virtual care offerings with the goal of improving access to healthcare care and are investing long-term in virtual care as a modality to complement their in-person services.

Sanford Health leverages a hub-and-spoke model, with TytoCare devices located in over 80 rural clinics and critical access hospitals in communities across the Sanford footprint in South Dakota, North Dakota, Minnesota, and Iowa. Virtual care is used across 70+ specialties including but not limited to behavioral health, family medicine, nephrology, sleep medicine, and reproductive endocrinology. Patients can connect remotely to clinicians, who can perform live remote physical exams, enabling the clinician to see live patient results and provide more accurate diagnoses on the spot. This technology enables Sanford Health to provide farther reaching access to both primary and specialist care close to home.

TytoCare brings specialists to rural, underserved areas

James Wallace, M.D., is a pediatric pulmonologist at Sanford Health, treating children with lung issues such as asthma and cystic fibrosis. Dr. Wallace is based in Sioux Falls, South Dakota, but today he’s seeing a patient more than 500 miles, and 7.5 hours away in Dickinson, North Dakota.


High visit resolution and reduced travel time mean quality care and satisfied patients 

With the help of TytoCare, Sanford Health has standardized the peripheral equipment available for clinicians to use when providing remote care to their patients. Every location that Sanford Health supports uses at least one TytoCare device to support the work of the virtual clinicians and enables them to significantly improve access to both primary and specialist care for patients across their footprint, regardless of their location.


Total TytoCare devices in clinics


Total completed visits

25.3 million

Total miles saved

1-3 hours

Travel time saved each way per patient


A successful implementation

Through their partnership with TytoCare, Sanford has succeeded in improving access to quality care across the vast geographical region that they serve. Patients who typically had to travel for hours to receive care are now able to connect live with a clinician and carry out full exams without leaving their community. Access to specialty care has become easier, with patients able to get second opinions or consult with specialty doctors without traveling to tertiary centers. The partnership has empowered patients to seek medical care and connect with their doctors whenever necessary and has allowed providers to make informed diagnoses and treatment decisions.


Virtual care for future generations 

Through its partnership with TytoCare, Sanford Health is improving access to care and health equity for its patients through virtual care. The health system is investing heavily in building an infrastructure that will enable them to scale their virtual care operations in the communities that they serve.

Sanford Health’s virtual care program officially began services in 2011. Federal grants funded operations to start and has evolved services across the Sanford Health footprint to connect to patients in their homes and to rural facilities.

In September 2021, Denny Sanford gifted Sanford Health $350 million for the ​Virtual Care Initiative. This initiative transforms health care across the Midwest by significantly improving access to convenient, high-quality health care via the expansion of the Sanford Health portfolio of services and treatment options for caregivers. By elevating the level of accessible care in the places we call home, Sanford Health lives out its mission of being Here for All. Here for Good.

As a result of this gift, Sanford Health’s virtual care services now include:

Educational and training opportunities for caregivers for seamless virtual experiences with advanced tools and technologies.

A team focused on research and development that creates and tests next-generation care solutions in a safe environment.

An interconnected network of satellite clinics that enable remote access for patient monitoring, assisted living support, access to primary care, specialists for consultations, mental health services, and other advanced resources.