This is one chapter of a four-part series that discusses the Digital Maturity Healthcare Journey and provides actionable advice on how to identify your current stage and how to progress upwards in your digital maturity journey as an organization. To check out the additional parts of this series, please visit....}.
In its Healthy People 2030 initiative, the U.S. Department of Health and Human Services outlines a set of national objectives to improve health and well-being through the end of the decade. A key focus of the initiative is to address the 5 Social Determinants of Health — the main socioeconomic factors that impact an individual's health outcomes — which include Economic Stability, Education Access & Quality, Neighborhood & Built Environment, Social & Community Context, and, of course, Healthcare Access & Quality. Achieving these goals will require systemic changes in many areas of our society, including making healthcare more accessible to historically underserved populations.
Digital healthcare solutions will play a major role in propelling the healthcare industry toward making these goals a reality. By deploying telehealth solutions, digital healthcare assistants, and smartphone-based healthcare platforms, healthcare providers have the potential to expand healthcare access to rural communities, elderly and disabled patients, and other vulnerable populations.
Telehealth Brings Distant Doctors Closer to Home for Rural Populations
For urban populations, access to a range of healthcare services and providers is often taken for granted. But the farther you get from the densely-packed city centers, research universities, and medical hubs, the fewer options you’re likely to encounter. Historically, rural communities are less likely to have access to diagnostic imaging equipment or medical specialists. For individuals living on remote farms, ranches, and other poorly-connected locations, even meeting with a primary care physician can be a day-long ordeal. Telehealth infrastructure helps providers bridge the urban-rural divide, connecting rural clinics with big-city specialists and making it easier for residents to access the specialized treatment they need.
This disparity is often a simple matter of economics. There may not be enough demand in a small community to support a full-time oncology department or a surgeon specializing in hip replacement procedures. But when a rural patient is diagnosed with cancer or has a nasty fall, their need for medical attention is just as important as any of their urban counterparts.
Until recently, for patients in these situations, the only option was to make the long journey into town to receive medical attention. In some parts of the country, a trip to see a specialist could be as far as 200 miles. Even patients with the means and flexibility to make the long trip, still have worse outcomes in an emergency. One study of car accidents found that a travel time of 30 minutes or more to a trauma center was associated with a 66% higher risk of death.
With the concentration of physicians continuing to shift toward urban areas, telehealth technology may be the only way to reverse the growing gap in death rates between urban and rural populations, which has tripled over the past 20 years.
Thankfully, the healthcare industry has already reached the point where providers can use digital tools to provide rural patients with clinical services, specialist consultations, and other medical resources — providing rural communities with many remote healthcare services with the same quality as in-person care.
Thankfully, healthcare technology has already reached the point where providers can use digital tools to connect rural patients with clinical services, specialist consultations, and other medical resources, and improving healthcare outcomes for everything from diabetes to stroke.
Digital Assistants Make Healthcare More Friendly for Elderly and Patients with Disabilities
For patients facing cognitive impairments and memory problems, such as the elderly or patients with disabilities, barriers to effective healthcare may have more to do with difficulties staying engaged than physical distance. It can be especially difficult for these patients to keep track of doctor visits, remember when to take each medication, and stay on top of medical records. Digital healthcare tools that can send reminders, help patients track appointments, and keep medical information organized can be a major boon for these patients.
When patients fail to take prescribed medications, miss doctor's appointments, and fail to keep up with their healthcare regimen, it can lead to serious negative health outcomes. Medical non-adherence is the leading cause of all treatment failures and is responsible for up to a quarter of all hospitalizations.
While there may be some initial challenges to getting more senior patients to adopt digital technologies, it makes sense for healthcare providers to invest in helping overcome the initial learning curve. When healthcare providers support their patients with personalized reminders of when to take their medications and help them stay on track with other healthcare-related tasks, it can drastically improve treatment outcomes, especially among older patients. In addition, automating tasks previously handled over the phone or in person by a staff member will free up essential employees so they can divert their focus to activities that are more important to patient outcomes.
mHealth Provides Underserved Populations More Flexible Options
Low-income and minority patients — populations who tend to be most in need of medical attention due to a variety of Social Determinants of Health — often face the most obstacles to accessing available healthcare services. These groups are the most likely to work in jobs that offer little or no paid sick leave. And even for the lucky few who do, lower levels of automobile ownership can make attending in-person doctor visits a struggle. mHealth, an abbreviation for mobile health and a term used for the practice of medicine and public health supported by mobile devices, provides a more flexible and accessible alternative to traditional clinic visits.
Around 3.6 million people across the country forgo medical care due to inadequate transportation. mHealth platforms, which often incorporate telehealth and remote patient monitoring elements, can make it easier for residents with reduced transportation options to access medical resources. This is especially important for low-income and minority individuals who are less likely to have access to personal transportation and are more likely to rely on public transport. Among urban residents, 34% of Black individuals and 27% of Hispanics report taking public transit daily or weekly, compared with only 14% of White people. We see a similar transportation gap among low-income individuals. 15% of individuals earning less than $30,000 per year report taking public transit daily or weekly, compared with only 8% of individuals earning $30k-$74,999.
While there is often substantial overlap between telehealth and mHealth, there is one key distinction that makes mHealth platforms especially valuable in the effort to increase healthcare access to underserved communities. mHealth platforms are exclusively designed to work on mobile devices such as smartphones — which for many households is their only reliable means of internet access. Among individuals earning less than $30k/year, fewer than 60% report having access to broadband internet at home. However, more than 75% have access to an internet-connected smartphone. As 4G and 5G coverage continues to expand, so too will more opportunity to leverage mHealth platforms to monitor and improve patient outcomes.
mHealth helps bridge gaps in access to care by allowing individuals to communicate with their healthcare providers and vice versa without meeting face to face and without the need for expensive computer equipment or high-speed internet at home.
Expanding Access to Digital Healthcare Will Improve Patient Outcomes
As access to quality healthcare becomes a reality for more of the population, the healthcare industry has the potential to improve patient outcomes not only for the newly-covered groups but for everyone. Greater access to healthcare for rural, minority, lower-income, and other underserved populations will result in more representation in collected medical data. This means more inclusive data sets and better medical research.
The growing body of medical records and patient data is already leading to remarkable breakthroughs and opening the door to personalized biomedical healthcare. Researchers are exploring new frontiers in medicine by using Big Data tools to integrate experimental laboratory results, healthcare records, and data from Internet of Things and wearable devices. But the quality of this research can only be as good as the quality of the data they have access to.
It’s no secret that, historically, medical research has had an overrepresentation of WEIRD populations — that is to say, research was done using individuals who live in Western, Educated, Industrialized, Rich, and Democratic societies.
We can see a prime example of this in the field of psychology. Given the costs and difficulty of recruiting research subjects, many researchers opt for the convenience of recruiting subjects from the university student body. This has led to research populations that were predominantly young, white, economically stable, and — unsurprisingly — college-educated. A similar lack of representation can be seen in drug trials. In the U.S., Black patients make up only 5% of participants in clinical drug trials, despite making up nearly 20% of the total population.
This type of underrepresentation in medical research can have serious consequences. As we’re beginning to learn thanks to the emergent field of Pharmacogenomics — the study of how an individual’s genes affect their response to medication — somewhere around 20% of drugs approved in the last few years have known racial or ethnic differences in disposition.
With more representation among historically underrepresented populations, medical researchers will have access to larger and more representative data sets—allowing them to uncover new and better ways of treating patients.
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This article is part one of a three part series about digital healthcare maturity as mentioned in the infographic. View the stages below:
Stage 1: Develop consumerism capability
Stage 2: Supercharge growth, engagement, and efficiencies
Stage 3: Anticipate and incentivize