Challenges & Opportunities For Medtech To Assist Rural Americans

By Waqaas Al-Siddiq, DBA, Biotricity

Rural Americans face significant health disparities compared to their urban counterparts. The population living in rural America has higher rates of chronic illness, disability, increased mortality rates, and lower life expectancies.¹ They are also, on average, older. Residents of rural areas live further away from healthcare facilities and are unable to see a physician for in-person care as often as urban residents. With difficulties taking time off work, transportation challenges, and mobility issues, location is a barrier to access for many. Social determinants of health experienced by these residents, like educational attainment, income-level, race/ethnicity, and health literacy also impact their ability to access care.²

Rural patients are also located further away from specialists that can treat complex needs. And it’s these complex problems that overburden the healthcare system, as chronic issues, gone untreated, will only worsen. These patients will need additional care that rural infrastructure cannot provide or they cannot access.

This is where medical device companies can step in, providing solutions that make it easier for physicians to provide care and for patients to access it. However, to best assist rural communities, it’s important to carefully study the needs of both patients and providers. By looking closely at how design, usability, and functionality can impact outcomes, medical device companies can help both patients and providers in rural communities.

Medical devices, especially remote patient monitoring, can help bridge the accessibility gap for rural patients – if designed, developed, and deployed correctly. In this article, I outline how medical device companies can help tackle these issues and implementation strategies that are important to consider for success.

Remote Patient Monitoring Is Particularly Poised To Benefit Rural Patients

Devices that can be used for remote patient monitoring (RPM) programs will be especially beneficial for patients in rural communities. The COVID-19 pandemic highlighted the importance of these devices in supporting connectivity and management while in the home, and these same benefits extend to rural areas (provided there is infrastructure available to support it).³ Rural patients also use hospital emergency services more frequently than those in urban areas, so RPM’s ability to reduce ER usage and readmissions will minimize costly expenditures.⁴

Since specialty providers are sparse in rural areas, and rates of chronic illness are higher, remote patient monitoring devices will be especially valuable here. RPM can play a critical role in chronic disease management by keep providers up to date on a patient’s condition between check-ins, minimizing the risk of deterioration and adverse events.

Devices that can monitor patients in real time will help improve outcomes in these areas as well.  Real-time monitoring capabilities will allow physicians to better track patient progress as time between appointments might be longer in rural areas and can reveal important information about changes in a patient’s condition that would otherwise be obscured.

RPM has already been shown to cut healthcare costs and improve outcomes for chronic illnesses. Medical device companies should be looking at additional areas of development here, addressing gaps in current solutions and building with new developments in healthcare IT in mind – like telemedicine, healthcare apps, and population health management.

Incorporating artificial intelligence, wireless sensor networks, integrated IT services, and analytics into your medtech will help assist providers in decision-making and triage, by detecting abnormal events and alerting providers to issues. It can also utilize predictive capabilities to catch changes in a patient’s condition before physicians themselves would be able to, avoiding expensive and harmful emergencies.

There are still other hurdles to consider. For example, many rural residents lack an internet connection – not just because of accessibility but often because of affordability. This will limit the use of integrated telehealth services that can work with a device and functions of the device itself.

Take The Patient-Centered Approach

To adequately serve these communities, medical device companies should take a patient-centered approach. Assessing the current and future needs of rural residents will assist in delivering the best care and help reduce health disparities.⁵

What does it mean to meet these patients where they are? Design equity in medical devices for rural communities requires working closely with users and integrating empathy into the design process. What are some of the frustrations they might run into using the product? What will make them comfortable enough to recommend it to a family member or friend? How can usability be tailored to these patients so that engagement is prioritized and better outcomes are achieved? Answering these questions, and incorporating their answers into development, will also be critical to prepare for the shift in value-based care.

For example, digital literacy is lower among rural residents, so patient comfort with healthcare technology can be a barrier to effective utilization and adoption among rural residents. It’s important to design with different levels of digital competency and to provide assistance when needed to reduce friction and promote usability. Since residents of rural communities are often older, they might have accessibility issues like impaired vision or mobility, which may make using the device more challenging. Healthcare technology should be easy to use and understand, and its benefits should be clear to the user – when patients are sufficiently educated and engaged with their treatment, outcomes improve. They’re more likely to adhere to their treatment plans and discuss their health with physicians.⁶

Devices that incorporate software that enables patient engagement like medication reminders, goal setting, activity challenges, and positive feedback mechanisms have been shown to improve outcomes as well.⁷ For patients in rural communities, these could serve as additional touchpoints to help manage their condition while at home, maintaining a critical level of connectivity.

As medical devices and remote monitoring solutions advance, they will increasingly become integrated with software and other digital healthcare services. Together with the data collected from devices that monitor patient vitals, this information could help physicians better understand patients’ conditions and respond accordingly, improving clinical decision-making and support.

Work Closely With Healthcare Providers And Stakeholders

Medical device companies should also work closely with providers and stakeholders during development to address their needs. Physicians in rural areas face their own challenges, and there continues to be shortages of healthcare professionals in rural areas – about 20% of the U.S. population live in rural areas, but only 9% of physicians practice there.⁸

Rural hospitals and facilities have the unique challenge of handling patients with high rates of chronic illness – expensive conditions that require continual management and treatment – with less revenue and funding than urban centers. Hospitals are closing due to a lack of funding or revenue, making it more difficult to recruit healthcare professionals to rural communities.⁹

Medical device companies should aim to make systems that work for physicians, too. Healthcare tools should enable them to do their job more efficiently, give better quality of care, and allow them to spend more time with patients. This means understanding providers’ pain points, which may include reimbursement challenges, workflow inefficiencies, and fragmented care solutions. Medical device companies should make implementation as frictionless as possible, supplying training to physicians and healthcare workers when necessary and providing accessible support.

It's also important to consider other healthcare IT tools the provider and facility are using, like the EHR, billing and claims services, and reporting systems.¹⁰ Currently, many tech-enabled healthcare services are fragmented and not equipped to handle the many different platforms, software, and services that physicians now utilize. The future of healthcare is moving toward integrated services, and to ensure success, medical device companies should work alongside care teams to understand how devices will integrate into current workflows. Look for opportunities to reduce physician pain points – not add to them.

Conclusion

Medical devices have the potential to change how healthcare is delivered in rural areas. New developments are making it possible to reach patients where they are, reducing accessibility barriers and improving management and engagement of health.

We must look to the future for effective applications of medical devices that can help reach underserved communities and incentivize providers to deliver the best care. Utilizing a patient-centered approach in development will help increase usability and adoption in rural areas. And thoroughly understanding the needs of providers and healthcare workers will help them better serve the patients in their communities by making healthcare delivery more effective, efficient, and user-friendly – while improving fiscal stability. Remote patient monitoring solutions can be especially useful here, solving multiple pain points for patients and providers in rural areas. While there are obstacles to bringing healthcare to rural patients, technology is making it possible to find solutions. Innovators in healthcare should look for opportunities in rural communities, despite the challenges, as helping these patients will help our healthcare system at large.

References

1. https://www.ruralhealthinfo.org/topics/rural-health-disparities
2. https://journalofethics.ama-assn.org/article/why-arent-our-digital-solutions-working-everyone/2017-11
3. https://www.mckinsey.com/industries/healthcare-systems-and-services/our-insights/covid-19-and-rural-communities-protecting-rural-lives-and-health
4.  https://labblog.uofmhealth.org/industry-dx/patient-visits-higher-at-rural-emergency-departments
5. https://www.healthit.gov/sites/default/files/pdf/hit-underserved-communities-health-disparities.pdf
6. https://www.healthaffairs.org/do/10.1377/hpb20130214.898775/full/
7. https://www.jmir.org/2016/4/e86/
8. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6140198/#b2-ms114_p0363
9. https://www.chcs.org/resource/telehealth-in-rural-america-disruptive-innovation-for-the-long-term/
10. https://www.nejm.org/doi/full/10.1056/NEJMra1806949

About The Author:

Waqaas Al-Siddiq, the founder of Biotricity, is a serial entrepreneur, a former investment advisor, and an expert in wireless communication technology. He has designed digital, analog, embedded, and micro-electro-mechanical products. As CEO of Biotricity, a medical diagnostic and consumer healthcare technology company, he has guided the company through every stage of bringing its biometric remote monitoring solutions to market.