This article by Ambra Health CEO, Morris Panner, was originally published in Forbes on June 30, 2020.
Over 120 rural hospitals have closed across America since 2010, out of which a record-setting 19 shut their doors just last year, leaving many Americans without health care services or facilities anywhere nearby. The struggle persists for those that remain open with many still at great risk of closing.
Rural Patients Endangered By Lack Of Access To Medical Care
This is a dire situation for rural communities, as reflected in a 2019 National Bureau of Economic Research study (registration required) that found how rural hospital closings increase the patient mortality rate by almost 6%, compared to urban hospital closures, which don’t show an impact on mortality. Having little or no medical support within proximity can be disastrous during an emergency when a patient requires immediate attention, such as a sudden heart attack, stroke or traumatic injury.
It isn’t just about urgent needs, though. Not having enough doctors, specialists or clinics close by also means people won’t get as much regular and preventative health care, leading to worse outcomes down the road. Even if there is a clinic within a reasonable distance, the medical staff could potentially lack the experience or equipment needed to diagnose certain conditions that will become problematic for the patient later on.
Serving Rural Communities Through Telehealth
While this situation may seem bleak, technology is providing the health care system with many promising ways of dealing with these problems. Telehealth, which has gotten increased use due to the coronavirus crisis, is especially key to tackling the rural health care challenge. Through videoconferencing, phone calls, texting, cloud-based image sharing and other means of connecting through remote technology, telehealth makes it possible for patients to consult with doctors from afar.
Telehealth can be especially effective when done in conjunction with remote patient monitoring technologies, such as portable equipment and electronics that patients keep at home to track their vital signs and other health measurements. This internet-enabled technology allows patients to perform tests that might otherwise have to be done in a medical office, and then share the results with their health care provider remotely to receive further advice.
New Funding For Upgrading Remote Technologies
The existence of telehealth and remote technologies doesn’t mean that there aren’t complications for implementation. Cost is already a major factor for many underfunded rural communities, which is why such a significant number of health care facilities are closing — or at risk of closing — to begin with. So how are they supposed to pay to install telehealth capabilities when money is scarce?
Fortunately, the CARES Act that was recently passed by Congress includes an FCC-run telehealth program that is supplying $200 million worth of funding for telecommunications services, information services and devices needed to provide virtual care. Eligible care providers include community health centers, local health departments, rural health clinics, not-for-profit hospitals, skilled nursing facilities, a consortium of health care providers and more.
The program offers an important opportunity for rural providers to either jumpstart or improve their telehealth capabilities. Already, organizations around the country have secured some of this funding for a variety of needs, including integrated telehealth platforms and systems, network upgrades, remote monitoring equipment, laptops and tablets, diagnostic equipment, cameras and displays, connected devices, telehealth software and telemedicine carts.
A New Way Of Caring
There may be some reluctance to take on telehealth when it feels so different to many people. Rural doctors who have taken great pains to build trust with patients may feel that a “video visit” is impersonal. Patients may be nervous about trying to use technology that they are unfamiliar with. And administrators may be concerned about logistical difficulties associated with implementing new technology, including getting all the chief decision-makers on board.
To deal with patient concerns, providers should try easing them into the idea rather than foisting it on them. Simply offering both choices — virtual or in-person visits — can be a good start. During in-person visits, patients can be introduced to telehealth processes and remote monitoring equipment by their doctor, and they can be given literature or tutorials that better explain how these options work. Starting with something easy, like showing the patient how they can send an email for a prescription renewal, might help introduce them to the convenience of telehealth.
Investing In Tech For The Future
These new systems and products are not only important for dealing with the current Covid-19 crisis but will also help make rural communities healthier overall as we step into the future. That future need not look as impersonal and robotic as some might fear. Instead, I think it will be a mix of the practical use of telemedicine (why go to the doctor to get your vital signs read if you can have a simple tech to do it at home?), video and text interactions with health care workers for quick advice or straightforward consultations, and in-person visits for in-depth exams and medical procedures.
Telehealth systems will enable people living in small towns and out in the country to communicate with a specialist in their condition hundreds of miles away so that they can get the kind of quality care that may not have been previously available to them. The patient may even be able to view one of their CT scans performed at the nearest imaging center and quickly transfer it to that specialist in order to get a better analysis.
Widespread telehealth adoption will help connect health care providers everywhere and integrate patients and data into a web of access. In this way, we can hope to see a world where health outcomes are no longer determined by whether you live in an urban or rural community.