MedCity Influencers, Diagnostics

Barriers to quality care—and how home testing can break them down

the pandemic has brought much-needed attention to how technology can help take down barriers to care and bridge care gaps—by shifting healthcare to people’s homes.

 

home care

Healthcare has improved by leaps and bounds over the past decades. But for far too many people, access to quality care remains frustratingly out of reach, resulting in major health disparities across wide swaths of society. This is especially concerning for people with chronic conditions, such as diabetes and hypertension, that require regular monitoring and treatment.

The coronavirus pandemic has further raised the barriers to care, thereby contributing to the neglect of essential health. But the pandemic has also brought much-needed attention to how technology can help take those barriers down and bridge care gaps—by shifting healthcare to people’s homes.

Transportation and Geography
Every year, 3.6 million Americans do not receive medical care due to transportation barriers. The reasons are varied. Everything from the lack of a vehicle or the funds necessary to afford transportation, to a disability that limits one’s mobility, can result in people staying home and not receiving the care they need.

While some notable initiatives address the transportation barrier, such as utilizing ridesharing services to provide affordable transportation to medical appointments, sometimes care is simply not available within a reasonable travel distance.

Americans in rural communities suffer from markedly higher rates of mortality and chronic conditions. With many rural hospitals shuttering, quality care is becoming even more distant for some of the people that need it most.

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A Deep-dive Into Specialty Pharma

A specialty drug is a class of prescription medications used to treat complex, chronic or rare medical conditions. Although this classification was originally intended to define the treatment of rare, also termed “orphan” diseases, affecting fewer than 200,000 people in the US, more recently, specialty drugs have emerged as the cornerstone of treatment for chronic and complex diseases such as cancer, autoimmune conditions, diabetes, hepatitis C, and HIV/AIDS.

Remote care has the potential to transform healthcare for anyone who has trouble getting to a clinic—be it 200 miles away, or just around the block—by shifting appointments and tests from medical facilities to people’s homes and allowing for the bulk of chronic condition management to be performed at home.

Human Behavior
For many people, the biggest barrier to effective care is one that they are intimately familiar with—their own lifestyles. Even with comprehensive health insurance and no transportation barriers, multifactorial influences on people’s eating, exercising and self-care routines can create suboptimal health conditions—often in the form of the chronic conditions that affect almost half of American adults. For the less fortunate, these challenges are often exacerbated.

One important way that remote care can help improve people’s behaviors is by seamlessly integrating into their daily lives. Removing the need to physically visit a clinic is a boon to convenience, making healthcare easier to prioritize. In that way, remote care is effortlessly patient-centric.

At their best, remote-care solutions don’t begin and end with a videoconference appointment but support people daily as they manage their health. For instance, by giving them the nudge they need to do an at-home urine test or check their sugar level, digital solutions can empower people to adopt a healthier lifestyle in ways that an annual checkup cannot.

Fear of Finding Out
One particularly unfortunate barrier to care is fear. FOFO—short for the Fear of Finding Out—causes many people to skip appointments that could lead to a diagnosis they find frightening. This is especially problematic because early diagnoses sometimes allow for early interventions that can spare people from more intensive or costly care in the later stages of a disease—and might even save their lives.

Remote care reaches people in their safe spaces—their homes—and has an important role to play in educating the public, increasing knowledge, and helping people better overcome their fears and anxieties. In the face of stigma, the burgeoning field of remote mental care can act as a discreet and comfortable solution.

Affordability
Nearly one in three Americans admit to not seeking medical care due to cost, according to a recent nationwide Bankrate survey. Remote care alone cannot solve the various global and local inequities adding to the high cost of healthcare, but it can certainly help (e.g. saving money on copays/clinic fees, lab testing/diagnostic fees, transportation costs, etc.). Remote care also doesn’t necessitate that people take off from work to get to an appointment and requires little more than a smartphone—making it perhaps the most efficient and cost-effective form of care.

Covid-19: Barrier and Opportunity
Virtually overnight, Covid-19 raised a significant barrier in the form of shelter-in-place orders—a new kind of transportation barrier of special pertinence to elderly people, expectant mothers, and people with chronic conditions. In the early days of Covid-19, more than half of older Americans delayed or canceled medical treatment.

The disruption wreaked by the virus increased fear to the nth degree, often making it challenging to lead a healthy lifestyle. The repercussions of such neglect could be devastating. But it also made clear the importance of equity in healthcare, as well as increased the awareness of remote care and its potential to help lower barriers for everyone in the long term.

For this to happen, remote care must become an integral part of treating non-acute, chronic conditions. Government actions, such as the recent Executive Order on “Improving Rural Health and Telehealth Access that expands regulatory flexibilities beyond the immediate pandemic crisis, are an important step. But more than anything else, remote care will require patients and clinicians to work hand in glove as care shifts from the clinic to the home.

Photo: laflor, Getty Images

Paula LeClair is the U.S. General Manager of Healthy.io—the company that transforms the smartphone camera into a medical device, enabling at-home urinalysis and digital chronic wound management. She has more than 20 years of experience in digital health solutions and medical device and technology enterprises.

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