List and define dependent and independent variables in the study " For this narrative review, we searched PubMed MEDLINE from January 2017 to December 2020. Key search terms included ("telehealth" AND "telemedicine"), "rural" AND "outcomes." Filters were applied to identify free full-text studies published in English over a 4-year period to include the most recent evidence available in this research area. We included randomized controlled trials, mixed methods studies, qualitative studies, post hoc analyses, and prospective and retrospective cohort studies. Included studies contained at least one type of telehealth service and one primary measurable outcome and were assessed in rural communities/settings. We excluded systematic reviews, meta-analyses, editorials, conferences, unpublished studies and abstracts, studies outside the United States, and articles that were missing criteria based on the Critical Appraisal Skills Programme criteria. The Critical Appraisal Skills Programme has developed a set of 8 critical appraisal tools to assess the quality of evidence-based research; they have been widely used in previous studies [5]. To organize our review of the literature, we used Covidence, a review management tool, to conduct a review of titles and abstracts, and a full review of the articles. We used Covidence to exclude duplicate records. Both authors screened studies for relevance based on titles and abstracts. Both authors reviewed the full-text articles of relevant arti