It’s an unfortunate reality of the US healthcare system that health disparities have long persisted across multiple years and populations, and that many patients have received less than adequate care due primarily to factors outside of their control. It is a great time for the industry to take all the learnings gained and leverage the advancements made in recent years to work towards health equity advancement. Health equity is the concept of ensuring that everyone has a fair and just opportunity to attain their full health potential, regardless of their race, ethnicity, gender, socioeconomic status, or other factors.
While the Covid-19 pandemic further exacerbated health disparities, it also raised awareness of the urgent need to take action. According to the recent Health Equity Outlook Report from EY, online searches for “health equity” have doubled over the past two years. Increasing understanding of this issue is a critical first step, but to truly achieve equity will require addressing the root causes of disparities and working to eliminate them. Remote patient monitoring (RPM) is one avenue toward beginning to make this a reality.
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RPM is the use of technology to remotely collect and transmit both physiologic and nonphysiologic health data from patients to healthcare providers, so physicians can quickly and easily monitor patients’ health statuses on an ongoing basis and in between in-person visits. By improving access to healthcare services, RPM holds immense potential to advance health equity.
Social determinants of health and their impact on health equity
Addressing the root causes of health inequities will have numerous benefits, particularly for complex patients who often face multiple health and socioeconomic needs. There is a growing body of evidence showing that when patients with social determinant of health barriers are given assistance with housing, food, and transportation, their use of emergency departments and other costly healthcare services often declines and is rather replaced by increased use of preventive and primary care services, according to studies done by The Commonwealth Fund.
Individuals in rural areas or underserved populations face many barriers to accessing care, and these individuals often end up with complex unmanaged needs. More than 46 million people in the US live in rural areas – and this is no small part of the country’s population. Yet, rural Americans are more likely to die from heart disease, cancer, and stroke, and deaths from unintentional injury are 50% higher in rural areas compared to urban areas, based on studies from the CDC. These populations are at a significant disadvantage when it comes to healthcare access and outcomes, yet the barriers that prevent them from finding and receiving quality care are often beyond their control.
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Florence Kariuki Florence Kariuki, RN, MHA, FHELA, is the Chief Clinical Officer at Health Recovery Solutions (HRS), leading the company’s clinical innovation and reimbursement strategies. In this role, she leads a team that works closely with hospitals, health plans, home health agencies, etc. to operationalize successful Remote Patient Monitoring and Virtual Care programs. Under her […]
Cost presents one major barrier to access. High out-of-pocket costs and fear of surprise medical bills often discourage healthcare consumption for individuals experiencing socioeconomic barriers. In a recent report, KFF found that people of color are more likely than their White counterparts to report not seeing a doctor in the last 12 months because of cost. In addition, people of color are less likely to be insured, have a regular healthcare provider, or see a doctor consistently. Another barrier to access is transportation. Not only can limited transportation options prevent individuals from reaching healthcare facilities and services, but they can also restrict access to healthy food options and employment opportunities – which further contributes to negative health outcomes, particularly for those in rural and low-income communities.
Language is another factor that influences people’s willingness and comfort in accessing care. For patients with Limited English Proficiency (LEP), finding care, booking appointments, and communicating with physicians at visits can all be significant challenges. Despite the rich language diversity in the US, most healthcare professionals only communicate with patients in English, creating significant gaps in providing quality healthcare to a growing LEP population. On a similar note, health literacy is a critical element that impacts how well people are able to access, understand, and apply health information. When literacy is limited, patients may not be able to understand options, manage conditions, or make decisions around their care.
How remote patient monitoring works
The recent growth in RPM has demonstrated its importance and potential to reduce or eliminate barriers and improve access to care for patients. By equipping patients with technologies such as wearable devices, smartphones, and other digital health tools, along with the appropriate training to effectively use those technologies, RPM enables patients to track their health status and share their data with providers from the comfort of their homes or alternative settings.
RPM programs increase access for anyone who could benefit from regular check-ins with healthcare professionals, as well as patients who could use support with managing their care but don’t require frequent in-person visits. RPM can be especially useful for managing newly diagnosed or chronic conditions, pregnancy and postpartum support, post-acute recovery, and palliative care, among many other care needs. RPM solutions facilitate ongoing care and support between office visits by enabling two-way communication for patients and their providers. The technology also improves transitions and continuity of care, as patients are able to have a smooth transition back home after an acute care event. By enabling real-time access to a patient’s health status, clinicians are able to provide timely interventions and avert potentially avoidable emergency department visits and hospital readmissions.
Receiving healthcare services and support at home will continue to become the standard of care, as millions more patients and providers continue to leverage RPM as an important component of hybrid care delivery.
How remote patient monitoring helps to address social determinants of health and advance health equity
Not only does RPM improve patients’ access to care in general, but it improves the quality of care being delivered by helping to address social determinants of health. Advancing health equity means reducing healthcare disparities, and RPM can play a critical role in achieving this by enabling patients to receive appropriate care in a timely manner. As patients receive care from a distance, transportation ceases to serve as a major barrier for those who live in rural or remote areas or who have mobility issues. Most high-quality RPM solutions also come with SIM cards that offer access to the internet, even in rural areas. By bridging the gap between patients and providers, access to care increases.
The ability to monitor and treat patients remotely can also help alleviate provider shortages. Not only is delivering care remotely quicker for the provider in many cases, but it also reduces wait times for patients, who may otherwise have to wait weeks or months for an appointment. This time can be the difference between an individual deciding to seek care or forego it.
RPM can help patients access culturally-sensitive care that is customized to their individual needs. Healthcare is not one-size-fits-all, and individuals in underserved populations have unique needs. RPM solutions can deliver health education materials in different languages and formats, and the patient can work through them at their own pace. Many programs also provide patients with easy-to-use communication tablets and other devices that are sensitive to health literacy limitations.
Because RPM allows for much more personalized care experiences, it improves patient engagement. Patients are able to track their own health data and make correlations on how their behavior impacts their health outcomes. This convenient capability makes patients more likely to engage in and adhere to their plan of care, leading to better health outcomes and therefore greater health equity.
Providers are able to monitor patients’ health statuses remotely and intervene when necessary, thus preventing health conditions from worsening. Improved management of chronic conditions reduces the disease burden and related disparities among the impacted populations. Many health systems that have implemented RPM have seen fewer patients utilizing emergency departments and achieved a reduction in hospital readmissions for patients enrolled in the program. They have also seen increased patient satisfaction and retention, which benefits both the patient and the health system.
The future of healthcare: achieving health equity
The growing attention and concerted effort towards improving health equity promise great things for the future, fueled additionally by the technological advancements that serve as tailwinds for progress. Both patients and providers today are much more comfortable using telehealth and other forms of virtual care than before the pandemic. By leveraging RPM and other digital health solutions as an important part of a multi-prong approach to care delivery, a future where all patients have equal access to high-quality healthcare becomes a closer reality.
Photo: Maria Symchych-Navrotska, Getty Images
Florence Kariuki, RN, MHA, FHELA, is the Chief Clinical Officer at Health Recovery Solutions (HRS), leading the company’s clinical innovation and reimbursement strategies. In this role, she leads a team that works closely with hospitals, health plans, home health agencies, etc. to operationalize successful Remote Patient Monitoring and Virtual Care programs. Under her leadership, the team enables client implementation of innovative digital health programs such as Hospital at Home, In-Patient Virtual Care, ED Triage and Diversion, Transitions of Care, Chronic Care Management, and many more. Ms. Kariuki also serves as the Chief Diversity, Equity, & Inclusion Officer at HRS.
Prior to joining HRS, Ms. Kariuki served in various leadership roles at Horizon Blue Cross Blue Shield of New Jersey, focused on innovation of Alternative Payment Programs, Value-Based Programming, Population Health Management, Social Determinants of Health (SDOH), Palliative Care, and Total Cost of Care Management strategies.
