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Advocating for underserved populations: Is remote patient monitoring the answer?


For years, healthcare providers have struggled to ensure that minorities, individuals residing in rural and low-income populations, and patients living with chronic conditions have equal access to the healthcare services they desperately need. In early 2020, the Covid-19 pandemic hit and fractured this divide even further. Today, these vulnerable populations are not only at a greater risk of contracting the coronavirus, but it has also become exponentially more difficult to ensure these patients receive even the basic care they need as a result of being disproportionately affected by Covid-19.

On the flip side, the pandemic era has ushered in a groundswell of new technology-oriented healthcare modalities, impelled by changes in regulations and reimbursements, as well as demand from – and acceptance by – providers and patients alike. Unfortunately, however, these new technologies often fail to be deployed in underserved communities. And given the success being achieved with remote care options — especially in being able to effectively reach those who have long been underserved — it’s crucial that today’s providers, innovators, and regulators alike continue to push for such tech adoption, driving virtual, continuous care in populations disproportionately affected by disease.

Exposing the Healthcare Challenges Impacting Vulnerable Populations
Race, ethnicity, socio-economic status and geography all play a role in whether an individual has adequate access to healthcare. Obesity, which is associated with many chronic diseases, impacts minorities more so than any other group. In fact, almost 22% of Hispanic children ages 2 to 19 are obese, while Mexican Americans, specifically, suffer more from diabetes than other Hispanics. Meanwhile, cardiovascular disease impacts nearly half of all African Americans and this population is 30% more likely than whites to die prematurely from heart disease – and two times as likely to die prematurely from stroke.

Similarly, where individuals live increases their likelihood of having a chronic disease. Incidences of heart disease in people residing in rural areas is 56% greater than those residing in metropolitan areas. They are also 75% more likely to have chronic lower respiratory diseases, like COPD.

Adding to this is the fact that rural and minority individuals also tend to go without needed care. African American and Hispanic adults are less likely to have a regular doctor or have had a health visit than whites, as many have barriers like lack of childcare and transportation, and they often have to schedule around hourly jobs and having little paid time off. Rural residents face other barriers, such as proximity to doctors, availability of providers, lower income and lack of insurance coverage.

Using Innovative Healthcare Technology to Bridge the Divide
Covid-19 has further exposed these inequities. But if there is any bright spot in the pandemic, it has been the way technology has been applied to ensure proper and adequate continuity of care.

Seeking to prevent the spread of Covid-19, many providers have turned to tools such as telehealth, asynchronous care and remote patient monitoring to see patients virtually while in-person visits were off the table. As a result, “Essentially overnight, as part of efforts to reduce the transmission of Covid-19, two of the major previous barriers to telehealth use – poor financial reimbursement and low provider willingness – were eliminated, thus massively speeding up adoption,” researchers wrote in a study published in the Journal of the American Medical Informatics Association. This confluence of factors is setting the stage for a greater reliance on virtual care in the post-Covid era, bridging the care gap underserved populations have historically faced. And notably, these virtual care models enable providers to be more proactive in addressing patients’ needs, which ultimately results in better outcomes.

Federally Qualified Health Centers (FQHCs) and Rural Health Centers (RHCs) are crucial components for ensuring providers can reach and improve care in underserved populations through greater adoption of such virtual care models. These community-based healthcare centers are safety nets for individuals in need, providing essential health services, such as primary care, chronic disease management and preventive care, even if patients have no health insurance — thus, greatly improving outcomes in such populations.

Regularly gathering information from connected devices, like scales, blood pressure cuffs, pulse oximeters and blood-glucose monitors, then connecting them with clinical data from electronic health records, doctors can proactively intervene if concerns arise and ensure patients stay on the right path. This approach can improve patients’ adherence to medication regimens, as well as make it easier for providers to share educational resources when needed and to determine when to further engage patients to keep them on a healthy track.

While there is great promise in leveraging these solutions to bridge the gap in treating underserved populations, FQHCs and RHCs are currently not eligible for RPM reimbursement. Until permanent change is made here, gaps in care will continue to exist. Virtual care solutions have already proven their effectiveness during the pandemic. Our industry must demand and advocate for lasting actions and policies to ensure vulnerable populations have equal opportunity to receive the care they need to manage chronic conditions and their overall health and wellbeing. By coming together as one, we can make this change possible.

Photo: Jae Young Ju, Getty Images

 



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