When you take a job in healthcare, whether it be a nurse, a physician, or a data analyst, you want to help people. Healthcare’s ultimate goal is to help people live healthier and happier lives. But not all lives receive equal care. The variables of accessing and providing care are innumerable in the United States. One of those barriers to care is living in a rural area, where one out of every five Americans lives. We understand that isolated locations make access to care challenging, but we’re just beginning to understand what can – and must —be done to leverage new technologies and improve the lives of these estimated 60 million Americans.
With national healthcare spending reaching trillions of dollars, it’s frustrating to see the disparities in health outcomes in rural areas, including drastically higher mortality rates than in urban areas. Likely a contributing factor to these mortality rates, chronic health conditions like heart disease, diabetes, and hypertension are found at higher levels, as well. There won’t be a silver bullet that eliminates these disparities, but before we attempt to fix the problem, we must identify it.
- Limited provider availability: Only 10% of all providers work in rural areas, even though 20% of the population lives in these areas. And the care offered in rural areas is getting harder and harder to access. Between 2013 and 2020, one out of every ten hospitals in a rural area closed.
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- Higher rate of healthcare disparities: With fewer options to receive care, there are few options for basic screenings. This lack of regular monitoring exacerbates these disparities. It’s less likely for people in rural areas to be monitored for heart disease, blood pressure, weight, or diabetes. Similar to these patients lacking adequate care, they often lack the educational tools to improve their care. When care options are already spread so thin, where does a patient begin in seeking the care they need and that will help them the most?
- Lack of health insurance: If patients can’t pay for care, they often won’t seek it. A majority of patients consider cost when seeking care. According to U.S. Census data, 10% of people in urban areas are uninsured. In rural areas, that number jumps to 12%.
- Long travel distances: A close colleague of mine lives a three-hour drive from the nearest medical center. Going to a doctor’s appointment during a lunch break is simply not feasible. She’s forced to utilize work benefits like paid time off to prioritize her health. She can group all her appointments to save time, money, and PTO if the various scheduling departments are in her favor.
- Lack of access to private or public transportation: Only some are fortunate enough to have access to personal transportation or a car. And often, rural communities don’t have access to public transportation. If people in rural areas cannot physically make it to their appointments, it presents another obstacle to receiving care.
- Lack of internet connection: According to the Federal Communications Commission, 17% of people living in rural areas don’t have broadband access. That means 10 million people in rural areas don’t have the possibility of connecting to a reliable internet connection, making ever-expanding browser-based telehealth services a moot point.
Over 60 million Americans are experiencing one or all of these hurdles to receiving adequate healthcare. These issues will persist, but some technologies and advancements can address these glaring problems facing so many people.
The Covid-19 pandemic showed us how useful of a tool telehealth is and continues to be. In the long run, it’s the lifeline that will significantly help rural healthcare to close the gaps in access to care. But telehealth isn’t perfect. Other technologies must be implemented alongside telehealth to truly provide a holistic strategy for improving care access in rural America:
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- Broadband: Connect the remaining unconnected people. At least allow them to be connected so they can access care. Government plans on both the state and federal level, like the “Internet for All” initiative, are working to address this discrepancy. The sooner it’s done, the better for the health of potentially millions.
- Wearables and wireless devices: These devices allow patients to monitor their health continuously, providing critical data to healthcare providers. Smart scales, blood pressure monitors, and glucose meters are all examples of devices that could signal a healthcare provider states away about potential warning signs for a rural patient. A significant challenge lies in ensuring these devices are affordable and accessible to rural populations. Fortunately, several organizations are working to provide these tools to underserved communities. With warning signs realized, care can be mobilized.
- Mobile care: We have to bring care to these people. Send mobile health clinics to rural communities. These mobile units can be equipped to provide a range of services, from mammograms to lab services. Telehealth is great, but some aspects of healthcare need a human touch.
- Data and analytics: Technology isn’t just about providing direct care; it can also help healthcare organizations identify trends and disparities. Robust data analytics platforms can track community health metrics, helping providers identify areas of need and allocate resources accordingly. Artificial Intelligence can analyze this data to determine disparities and trends. AI can also improve healthcare searches. If a patient lacks the education to truly understand where to access care, an AI-powered provider search would point the patient in the right direction.
- Mail-order pharmacies: By delivering medications directly to patients, mail-order pharmacies ensure that rural residents have access to the medications they need without making long trips to the nearest pharmacy. Pill packs, which organize medications into easy-to-understand packets, are making it easier for all patients, no matter where they live. With them, patients take the right medication at the right time, reducing the risk of errors while promoting medication adherence.
- Drones: It sounds like science fiction, but it’s not. During the beginning of the Covid-19 pandemic, drones were used to deliver personal protective equipment and food. When done on a larger scale, prescriptions and vaccines can be distributed at a greater pace. The technology is being used for lab samples at some health systems.
People working the most vital occupations, like farmers and ranchers, call the most remote areas in this country home. Their health shouldn’t suffer due to their choice of employment. And while there are certainly more barriers to care than the solutions mentioned in this article, connecting people in rural places to better healthcare is possible. Telehealth is immediate, and proven to be effective in improving care for rural residents. But, there are other technologies and solutions that need to be utilized and invested in more significantly if we want to truly improve the health and the lives of these 60-million rural Americans.
Photo: Igor Nikushin, Getty Images
Karen Conley DNP, RN, NEA-BC is the VP of Clinical Services at Kyruus Health. She heads up the organization’s Patient and Family Advisory Council (PFAC). Through the PFAC she is able to learn first hand how patients, from across the country, including rural areas, are accessing healthcare and where they are running into barriers.
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