How Rural Health Drives Tech Innovation

February 05, 2018
How Rural Health Drives Tech Innovation

Given the density of city populations, one might think that it would be easier to attain quality healthcare in these areas, but most who study or practice urban healthcare know this is not the case. A wide variety of issues — including fewer physicians and nurses, lack of affordable care, transportation challenges, and high concentrations of aging populations — make the need for smart city healthcare more necessary than ever. Because of the rapid migration into cities, these problems are at the forefront of healthcare technology innovation.

However, despite significant increases in urban populations, more than 45 percent of the earth’s inhabitants still live in rural areas. This has become the real hotbed for healthcare innovation, rural health, where many of the issues require much more complex and expansive technology solutions.

Many of the challenges of rural health delivery are apparent, but key to reaching widely dispersed patient populations is the availability of telecommunications infrastructures.

According to the U.S. Federal Communications Commission (FCC):

  • 39 percent of rural Americans (23 million people) lack access to 25 Mbps/3 Mbps.
    • By contrast, only 4 percent of urban Americans lack access to 25 Mbps/3 Mbps broadband.
  • 41 percent of Americans living on Tribal lands (1.6 million people) lack access to 25 Mbps/3 Mbps broadband
  • 68 percent living in rural areas of Tribal lands (1.3 million people) lack access.
  • 98 percent of those living in rural territorial areas (1.1 million people) lack access.
  • 66 percent of Americans living in U.S. territories (2.6 million people) lack access to 25 Mbps/3 Mbps broadband.

To reliably delivery rural healthcare, hundreds of miles of driving must be eliminated. And because this all will be hinged on emerging telemedicine technologies, the reliability of a high speed telecommunications infrastructure is no small matter. Consider the rapid transmission of highly detailed medical images from a remote trauma center that require immediate evaluation in a secondary setting where a specialist is located. In an example like this, the elimination of pixilation, slow screen rendering, and slow downloads become matters of life and death.

From there, the challenges move to the technology workforce and funding. Rural healthcare facilities run on painfully tight budgets and spartan staffing. While some healthcare professionals may decide to move to, or remain in, rural areas, many are driven to move to suburban or urban healthcare facilities for higher pay and increased professional growth.

If the deployment of a telemedicine strategy in well-endowed metropolitan providers is challenging, the rollout of such initiatives across expansive rural areas becomes exponential.

A clinical professional’s natural enemy is increased workflow in a patient engagement setting. With limited staff and telemedicine expertise, the rural healthcare setting is especially prone to pushback on technologies that will decrease patient satisfaction and value of care — issues to which payers have become extremely sensitive. This frustration increases when the patient is being monitored from hundreds of miles away and the clinician has an inability to rule out a false-positive by having the patient come in for a quick outpatient visit.

Add to this the increasing pressure the clinician and Chief Medical Officer are under to justify the value of care delivered so as to get reimbursements from insurance companies. While rural telemedicine is a game changer in providing care to those who would otherwise never get it, many payers remain suspicious and deny payments unless the technology provides empirical advantages and reliable outcomes.

Finally, usability of devices and interfaces is foundational to rural health innovation. The mortality and morbidity rates of rural health patients tend to be much higher than those in urban and metropolitan settings. This means the complexity of diagnostic and treatment strategies can be come equally as complicated. Many rural patients are at best digital immigrants and at worst technology phobic. As such, healthcare professionals may be wary about depending on devices for analysis of a patients ailment or treatment. Making incredibly technical devices as simple as possible to use can be as difficult as creating the technology in the first place.

Frank Cutitta is an Editor-at-Large for Smart & Resilient Cities.

Frank Cutitta

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