Can digital health technologies improve access to care?
The Digital Health for Equitable Health Alliance and other initiatives aim to support care delivery for minorities and achieve health equity.
Healthcare availability, access and delivery have been compromised for low-income, minority and underserved populations for far too long.
In many metropolitan areas, citizens exist in healthcare deserts that make it difficult for people to seek healthcare when they need it or from conveniently maintaining healthcare therapies. This results in populations of patients that are high risk for receiving needed healthcare services, thus discouraging healthcare providers from extending care to these citizens.
The COVID-19 pandemic exacerbated the chasm between the haves and have nots. Many minority groups experienced higher rates of sickness and death from COVID-19. Key factors driving healthcare inequity include economic stability, neighborhood and physical environment, education level, food availability, community/safety/social context, and community healthcare systems.
An Altarum report identifies a potential economic gain of $135 billion per year if racial disparities in health are eliminated, including $93 billion in excess medical care costs and $42 billion in untapped productivity. People of color are projected to represent 50 percent of the U.S. population by 2050, so that is a significant driver in the push to reduce healthcare costs and improve care quality and treatment outcomes for all citizens by the federal government.
As the pandemic has taught us, digital technologies will be a significant foundation for reshaping healthcare services to achieve the quadruple aim of reducing healthcare costs, improving population health and patient experience, and improving the well-being of healthcare teams.
A new alliance announced in May – the Digital Health for Equitable Health Alliance – aims to improve health equity through the expansion of digital health innovations. The alliance membership comprises historically black colleges and universities, patient and physician advocacy organizations, and corporate organizations – they all have the mission to improve access to care in underserved organizations.
The alliance will focus on reducing health disparities for low-income, minority and underserved populations in the U.S. using digital health. The alliance will promote policies and programs to increase individuals’ access to healthcare by expanding innovations involving telehealth, wearables, artificial intelligence and machine learning.
An example of a company focusing on delivering equitable healthcare services via digital technologies is Amazon Web Services. The AWS Healthcare Accelerator has been established to focus on health equity. The accelerator includes a $40 million commitment that the organization made to support start-up entities that are developing solutions to reduce health inequities.
The AWS program will support 10 start-ups with technical, business, and mentorship programs. The start-ups must be U.S.-based or have existing operations in the U.S. if they are international. The start-ups will be considered for funding if they focus on one or more areas, including improving access to health services, reducing disparities by addressing social determinants of health, and leveraging data to promote equitable and inclusive systems of care.
The Digital Health for Equitable Health Alliance and AWS Healthcare Accelerator provide great examples for resolving healthcare inequities in this country.
Aiming to boost social stability
The current U.S. healthcare system is based on providing care to people who have insurance, and a large portion of our population that does not have Medicare or Medicaid does not have access to health insurance through their employer or simply can’t afford the outrageous cost of current healthcare policies. This population of citizens is predominately represented by minorities in underserved communities that local healthcare providers couldn’t care less about supporting.
Emerging digital healthcare solutions where smartphones provide access to symptom checkers can provide diagnostic tools (such as cardiac rhythms and voice biomarkers), identify and resolve SDOH challenges, connect people to community health centers and enable better healthcare for these citizens.
Many organizations have good intentions
While the Digital Health for Equitable Health Alliance and AWS Healthcare Accelerator are good examples of how organizations and companies are stepping forward to resolve the healthcare inequity challenge, these programs cannot falter. Failure to deliver tangible and quickly adopted digital solutions to help impacted populations of citizens will result in social disruption. Payers and pharmaceutical companies need to join these efforts.
Here are some crucial success factors:
Providers should identify minority citizens that qualify for Medicaid, enroll them and use digital health solutions to better manage their healthcare as a starting point.
This country’s healthcare system promotes inequity of care for minority citizens who do not have access to affordable healthcare coverage. Many minority citizens forgo healthcare insurance because it is too expensive, and when they need healthcare, they are often bankrupted for the services they receive.
A visit to an emergency department for a potential stroke evaluation can easily cost $30,000. This significantly impacts the lifestyle of lower-income citizens, who now have additional financial liabilities to contend with.
This is an ethical, moral and social embarrassment for the U.S. The pandemic has highlighted the challenges the country faces for delivering care equally across all patient populations. While digital health technologies cannot resolve the access-to-care issue such as insurance affordability, they can improve care delivery with lower cost solutions that improve care quality. Digital technologies will be the foundation for virtual care that is likely to provide more affordable services for low-income citizens if we can price that care fairly.
Mike Davis is an analyst for KLAS Research. This column was originally published on the KLAS website here.
Je, teknolojia za afya za dijiti zinaweza kuboresha upatikanaji wa huduma? Ushirikiano wa Afya ya Dijiti kwa Afya ya Usawa na mipango mingine inakusudia kusaidia utoaji wa huduma kwa wachache na kufikia usawa wa afya. Upatikanaji wa huduma za afya, upatikanaji na utoaji umeharibiwa kwa watu wenye mapato ya chini, wachache na wasio na huduma kwa muda mrefu sana. Katika maeneo mengi ya mji mkuu, wananchi wapo katika jangwa la huduma za afya ambalo hufanya iwe vigumu kwa watu kutafuta huduma za afya wakati wanahitaji au kutoka kwa kudumisha matibabu ya huduma za afya. Hii inamaanisha idadi ya wagonjwa ambao wana hatari kubwa ya kupokea huduma za afya zinazohitajika, na hivyo kuwazuia watoa huduma za afya kupanua huduma kwa raia hawa. Janga la COVID-19 limezidisha pengo kati ya wenye mali na wasio na mali. Makundi mengi ya watu wachache yameshuhudia viwango vya juu vya magonjwa na vifo kutokana na COVID-19. """Vitu muhimu vinavyoendesha ukosefu wa usawa wa huduma za afya ni pamoja na utulivu wa kiuchumi, mazingira ya jirani na ya kimwili, kiwango cha elimu, upatikanaji wa chakula, mazingira ya jamii, usalama na kijamii, na mifumo ya huduma za afya ya jamii." Ripoti ya Altarum inabainisha faida ya kiuchumi ya $ 135 bilioni kwa mwaka ikiwa tofauti za rangi katika afya zitasafishwa, ikiwa ni pamoja na $ 93 bilioni katika gharama za ziada za huduma za matibabu na $ 42 bilioni katika uzalishaji usio na faida. Watu wenye rangi ya rangi wanatarajiwa kuwakilisha asilimia 50 ya idadi ya watu wa Marekani ifikapo mwaka 2050, na hivyo kuwa kichocheo muhimu katika kushinikiza kupunguza gharama za huduma za afya na kuboresha ubora wa huduma na matokeo ya matibabu kwa wananchi wote na serikali ya shirikisho. """Kama janga hilo lilivyotufundisha, teknolojia za dijiti zitakuwa msingi muhimu wa kurekebisha huduma za afya ili kufikia lengo la mara nne la kupunguza gharama za huduma za afya, kuboresha afya ya idadi ya watu na uzoefu wa mgonjwa, na kuboresha ustawi wa timu za huduma za afya." Muungano mpya ulitangazwa mwezi Mei - Digital Health for Equitable Health Alliance - unakusudia kuboresha usawa wa afya kupitia upanuzi wa uvumbuzi wa afya ya dijiti. Ushirikiano huo unajumuisha vyuo vikuu na vyuo vikuu vya kihistoria vya weusi, mashirika ya utetezi wa wagonjwa na madaktari, na mashirika ya ushirika - wote wana utume wa kuboresha upatikanaji wa huduma katika mashirika yasiyo na huduma. Muungano huo utazingatia kupunguza tofauti za afya kwa watu wenye mapato ya chini, wachache na watu wasio na huduma katika Marekani kwa kutumia afya ya dijiti. Muungano huo utaendeleza sera na programu za kuongeza upatikanaji wa huduma za afya kwa watu binafsi kwa kupanua uvumbuzi unaohusisha telehealth, vifaa vya kuvaa, akili bandia na kujifunza mashine. Mfano wa kampuni inayozingatia utoaji wa huduma za afya za usawa kupitia teknolojia za dijiti ni Huduma za Mtandao za Amazon. AWS Healthcare Accelerator imeanzishwa ili kuzingatia usawa wa afya. Msaada huo unajumuisha ahadi ya $ 40 milioni ambayo shirika hilo lilifanya kusaidia mashirika ya kuanza ambayo yanaunda suluhisho za kupunguza ukosefu wa usawa wa afya. Programu ya AWS itasaidia waanzilishi 10 na programu za kiufundi, biashara, na ushauri. Kampuni mpya lazima iwe na makao yake makuu nchini Marekani au kuwa na shughuli zilizopo nchini Marekani ikiwa ni kimataifa. Kampuni mpya zitazingatiwa kwa ufadhili ikiwa zinazingatia eneo moja au zaidi, ikiwa ni pamoja na kuboresha upatikanaji wa huduma za afya, kupunguza tofauti kwa kushughulikia sababu za kijamii za afya, na kutumia data kukuza mifumo ya huduma ya usawa na ya ujumuishaji. The Digital Afya kwa ajili ya Haki ya Afya Alliance na AWS Afya Accelerator kutoa mifano kubwa kwa ajili ya kutatua ukosefu wa haki ya huduma ya afya katika nchi hii. Mfumo wa sasa wa huduma za afya wa Marekani unategemea kutoa huduma kwa watu ambao wana bima, na sehemu kubwa ya idadi yetu ya watu ambao hawana Medicare au Medicaid hawana upatikanaji wa bima ya afya kupitia mwajiri wao au kwa urahisi hawawezi kumudu gharama kubwa ya sera za sasa za huduma za afya. Idadi hii ya raia inawakilishwa hasa na wachache katika jamii zisizo na huduma ambazo watoa huduma za afya wa ndani hawawezi kujali zaidi kuhusu kuunga mkono. Ufumbuzi wa huduma za afya za dijiti zinazojitokeza ambapo simu mahiri hutoa ufikiaji wa wachunguzi wa dalili zinaweza kutoa zana za utambuzi (kama vile rhythms ya moyo na biomarkers za sauti), kutambua na kutatua changamoto za SDH, kuunganisha watu na vituo vya afya vya jamii na kuwezesha huduma bora ya afya kwa raia hawa. "Wakati huo huo, ""Digital Health for Equitable Health Alliance"" na ""AWS Healthcare Accelerator"" ni mifano mizuri ya jinsi mashirika na makampuni yanavyoendelea kuunda changamoto ya usawa wa huduma za afya, programu hizi haziwezi kushindwa." Kushindwa kutoa ufumbuzi halisi na wa haraka wa dijiti kusaidia idadi ya wananchi walioathiriwa kutaongoza kwa usumbufu wa kijamii. Watoaji na makampuni ya dawa wanahitaji kujiunga na juhudi hizi. "Hizi ni baadhi ya sababu muhimu za mafanikio: ""Watoa huduma wanapaswa kutambua wananchi wachache ambao wanastahili Medicaid, kuwaandikisha na kutumia suluhisho za afya za dijiti kusimamia vizuri huduma zao za afya kama hatua ya kuanza.""" Mfumo wa huduma za afya wa nchi hii huendeleza ukosefu wa usawa wa huduma kwa raia wa wachache ambao hawana upatikanaji wa chanjo ya huduma za afya ya bei nafuu. Wananchi wengi wa jamii ndogo-ndogo huacha bima ya afya kwa sababu ni ghali sana, na wanapohitaji huduma za afya, mara nyingi wanashindwa kupata huduma wanazopokea. Kutembelea kituo cha dharura kwa ajili ya uchunguzi wa uwezekano wa kiharusi kunaweza kugharimu dola za Marekani 30,000 kwa urahisi. Hii inaathiri sana mtindo wa maisha wa raia wenye mapato ya chini, ambao sasa wana majukumu ya ziada ya kifedha ya kushughulika nayo. Hii ni aibu ya kimaadili na kijamii kwa Marekani. Janga hilo limeonyesha changamoto ambazo nchi inakabiliwa nazo katika kutoa huduma kwa usawa kwa idadi ya wagonjwa wote. Ingawa teknolojia za afya za dijiti haziwezi kutatua suala la upatikanaji wa huduma kama vile gharama ya bima, zinaweza kuboresha utoaji wa huduma na suluhisho la gharama ya chini ambayo inaboresha ubora wa huduma. Teknolojia za dijiti zitakuwa msingi wa huduma ya virtual ambayo inaweza kutoa huduma za bei nafuu kwa wananchi wenye mapato ya chini ikiwa tunaweza bei ya huduma hiyo kwa haki. Mike Davis ni mchambuzi wa KLAS Utafiti. Makala hii ilichapishwa awali kwenye tovuti ya KLAS hapa.