A growing and aging population is placing the U.S. on the brink of a severe physician shortage. Recent data from the Association of American Medical Colleges (AAMC) has us slated for a shortage of nearly 122,000 physicians by the year 2032, with rural and underserved communities likely to face the greatest impact.
For these vulnerable groups, coordinating healthcare services is particularly complex, as evidenced by the mortality rates. According to the CDC, Americans living in rural areas are more likely to die from five leading, potentially preventable causes — heart disease, cancer, unintentional injuries, chronic lower respiratory disease and stroke — than those living in urban areas. An increasing number of hospital closures in these already resource-scarce communities — 120 over the last 10 years, according to research from the University of North Carolina — is exacerbating the disparity for people already dealing with a number of social determinants and other barriers to care, such as lack of transportation, housing, food and employment.
Innovations in telehealth and virtual medicine are a promising step in the effort to reduce socioeconomic disparities and their impact on health outcomes by empowering consumers with the means to manage their health and enabling the more efficient use of healthcare resources. Here, we’re exploring how these programs and the technologies that support them can help bridge the gap in physician supply and demand before it becomes a national health crisis.
Reshaping the Value Chain: Bringing Healthcare to the Consumer
The ability to reach patients when, where and how it matters most addresses a number of care-inhibiting factors, while potentially reducing costly, avoidable and, in many cases, inaccessible emergency care. Through technologies like remote patient monitoring and mobile health tools, data can be exchanged directly from patient to provider for proactive risk identification and intervention. Combined with tailored engagement and education around chronic disease management and post-acute care, these tools aim to reduce hospital admissions — and readmissions — helping to maximize physician time and prevent poor health outcomes.
New rules and payment models are being developed to facilitate the right care, at the right time, in the right place. One such regulatory push is the Centers for Medicare & Medicaid Services’ (CMS’) Emergency Triage, Treat and Transport (ET3) model, which expands Medicare reimbursements for on-the-ground ambulatory services beyond direct transport to an emergency department or other acute setting. Under the new model, CMS will pay participating providers for transporting patients to lower-acuity settings when appropriate as well as for treatment in place services performed by a qualified practitioner — either on-scene or via telehealth connection.
Physician burnout is a significant threat to the sustainability of healthcare, with the Massachusetts Medical Society designating it a public health crisis in a 2018 report. For providers serving low-income, often comorbid populations, the characteristics that define burnout — emotional exhaustion, depersonalization and sense of low personal accomplishment — are particularly concerning.
While the role of virtual medicine in reducing burnout has been well documented, the Rural Health Information (RHI) Hub notes an interesting reason as to why specifically this is the case in rural communities: it can enable a higher level of team-based care and collaboration among peers. In a New England Journal of Medicine article highlighting testimonials from healthcare providers practicing in rural America, Arkansas OB-GYN Dr. Wilbur Hitt states, “Telemedicine fosters a collaboration that reduces the feelings of isolation that physicians may experience when they go to practice in a small town.”
Increasing Access & Availability
With fewer hospitals and care centers come several barriers to access, including overcrowding, excessive wait times, prohibitive travel distances and more. Remote monitoring and virtual health programs not only enable providers to serve a greater number of patients, but also help to ensure resources are made available to those in need of critical in-person care — for instance, increasing the number of available hospital beds and minimizing the costly and far-reaching impact of appointment no-shows.
Innovations enhancing the viability of telehealth and telemedicine are vital to ensuring America’s most vulnerable populations have access the care they need when they need it. Expansion of these programs and advancements in population health management technologies present significant potential in reducing the impact of hospital closures in rural areas, while maximizing available resources to help mitigate future closures.
How are you using technology to provide greater access to care?