Many opinions have been swirling about this technology for the past several weeks, but whether we like or dislike the idea of this technology may be immaterial. The fact is if technology is easy to use and improves our lives – like the iPhone appears to – then it is here to stay. Electronic health record (EHR) systems are like ChatGPT; we can see their utility and imagine how they will facilitate care that saves and improves patients’ lives, but they’re not all the way there, not yet.  But we need to get them there – and quickly. We can.

Information is not only today’s currency; access to it is also often the difference between life and death in medicine. We have all seen firsthand how fragmentation in the health ecosystem overwhelms professionals at the front lines of patient care. Unable to access siloed information, providers often lack the background to make timely, life-sustaining decisions. This leads to poorer patient outcomes, added costs, and health professional burnout.  It results in health disparities unaddressed and the inability to engage effectively in treatable noncommunicable illnesses.

Providers and payers operate within silos, with little economic incentive to collaborate. The resulting fragmentation means that patients often fall through gaps in care as their cases are handed off from one team to another. The need to foster coordination between health stakeholders and technology has great potential, but culture and old habits can crush change.

Too Busy to Read Patient Records

As hospital floor shifts change, health professionals have little time to “get up to speed” on their patient responsibilities – and nurses are often assigned to different floors on successive shifts, making it difficult for them to gain experiential knowledge of a patient’s needs. This makes the EHR the only way to learn about their charges, which is a tenuous situation.

I know this too well. During the last 12 days of my physician father-in-law’s life, a nurse at a leading hospital replied to my questions about his care with a worrying admission: “I don’t have time to read patient records.” That admission is symptomatic of systemic failures. EHRs are not standardized; patient data cannot easily be shared between providers or accessed by patients visiting multiple hospitals. This leads to duplicative tests and procedures and can lead to medical errors and misdiagnoses, sometimes with catastrophic consequences.

For the sake of patient’s lives and health, that technology needs to be easier to use and needs to improve patients’ lives.  There must be interoperability between health systems and technology platforms.

Solutions from Government and the Private Sector

Thomas Mason, MD, Chief Medical Officer, U.S. Department of Health and Human Services, Office of the National Coordinator for Health IT, a long-time public health advocate, is among the nation’s leading experts addressing the challenges of patient care, technology, and information. Dr. Mason believes that interoperability is crucial for delivering quality care to patients. He’ll share his thoughts at the upcoming American Telemedicine Association meeting in San Antonio about The State of Interoperability in Transforming Healthcare with fellow industry expert Ardy Arianpour, a passionate entrepreneur and CEO of Seqster, a healthcare data management platform.

“Interoperability is essential for improving patient outcomes and reducing healthcare costs,” says Dr. Mason. “When providers can access complete and accurate patient information, they can make better-informed decisions about their care.”

Arianpour agrees. “The lack of interoperability between healthcare systems remains a major challenge. Electronic health records are not standardized, making it difficult for healthcare providers to exchange patient data.” To overcome this challenge, Arianpour believes telemedicine and remote patient care are essential tools. “Telemedicine can help to bridge the gap between patients and providers by allowing them to communicate remotely. This improves patient access to care and makes it easier for providers to monitor their patient’s health and deliver timely interventions.”

However, telemedicine and remote patient care are only part of the solution. Too often, the patient clinical data needed for prior authorization for payer approvals operate across different data systems with different electronic standards for storing the information. That adds to the physicians’ workflow and delays patient care. True interoperability – meaning seamless data exchange between health systems – is the key to curing fragmentation in the health ecosystem and providing genuine, patient-centered care.

In short, the system has to revolve around the patient, not the platform.  Right now, it just…doesn’t.

Patients are not empowered to take control of their medical destiny. Many lack access to reliable health information, and those with chronic conditions often struggle to manage their records. Instead of being at the center of care, they are often on the outside, looking in.

So, what can be done to address this isolation? Can it be solved by better coding and coordination of technology by technologists? Or must there be more to it?

Taking Action, Making Changes

To bring existing technology forward to the point where it breaks information logjams, heals fragmentation, and puts patients back at the center of care, five solutions need to be prioritized:

1. We need to break down the silos within the health provider community, improving and leveraging technology so that it supports collaboration between providers and payers to ensure patients receive seamless, coordinated care that keeps them healthier.

• We have to remember that hospital staff are often overworked and sometimes, managed less than optimally.  As we’ve seen, they may lack time to read patient histories.  Perhaps using AI developments that can provide concise patient histories with prioritized care notes – programs like Chat GPT, for instance – can help convey what is critical for providers to know.

• We need to harmonize clinical and administrative data systems to improve workflow and eliminate time-consuming, payer-specific requirements that providers often must address before delivering efficient care.

• We need to invest in interoperable technology that allows for the seamless exchange of patient data between providers. This will improve patient outcomes and reduce healthcare costs by eliminating duplicative tests and procedures.

• Finally, patients also need to be empowered to take control of their health. This means providing user-friendly interfaces that give patients access to reliable health information and the tools to manage their care, which connect to EMRs and patient portals. This is particularly important for people living with the challenges of chronic conditions.

Our healthcare system needs to be more cohesive, efficient, and cost-effective. While we have spent billions developing the technological tools we are confident can help drive this system-wide improvement, we must face the reality that the situation is worsening. We are spending more and seeing patient outcomes decline. 

Riffing on iconic advertising giant David Ogilvy, innovation theorist John Nosta writes, “GPT is like a lamp post to an intoxicated person at night. It provides support but not illumination.” Interoperability is designed to lift up health professionals and patients – healers and those seeking to be healed.  If so, it will soon illuminate the best path to care once we harken to the words of Dr. Thomas Mason and Ardy Arianpour.

Maybe it’s time we start with this simple idea; if the technological solutions we develop don’t make patients’ and health professionals’ lives easier, it’s as though they were never created.

[Special thanks to authors John Bianchi and Cullen Burnell for their review of this article.]

The post Stop Making Excuses. Prioritize People! appeared first on Medika Life.

This land is your land, this land is my land
From California to the New York island,
From the redwood forest to the Gulf Stream waters;
This land was made for you and me.

That Guthrie song, with its heartfelt words, offered conflicting images of a nation’s greatness and the great strife of its people – the never-ending tension between grander and affliction. The power of his lyrics – with verses too conveniently edited out to make the song a patriotic hymnal rather than the composer’s original intent – is a call to social consciousness. The classic 1940s folk song was written to spark a social impact edge to address the needs of overlooked citizens.  The poverty Guthrie saw as he crisscrossed America’s dustbowl states continues. The reasons may be different; however, the suffering remains.

In a recent New York Times opinion piece, Tony Pipa, a senior fellow at the Center for Sustainable Development at the Brookings Institution, who leads the Reimagining Rural Policy Initiative, working to transform U.S. policy to enable equitable and sustainable development across rural America, writes:

“Too often policymakers mistake agricultural policy for rural policy. Farming now accounts for just 7 percent of rural employment. Service jobs, retailing, manufacturing and government employment all outweigh agriculture. And while $163 million of the relief the Trump administration distributed during the peak of the trade war with China went to high-income farmers making more than $900,000 annually, small-scale and family farmers are increasingly taking off-farm jobs just to get by.”

Today, more than 46 million Americans live in rural communities.  On average, rural locales lag behind non-rural communities on every measure of prosperity, from poverty rates to employment opportunities. This land may have been “made for you and me,” yet, when it comes to access to care, rural Americans live hours away from basic medical care, emergency services, and specialist providers.  Their well-being – survival – often hangs on a limited broadband connection. The system to address their needs is usually based on urban and suburban expectations.

Rural community populations trend older than urban and suburban regions, and while age is an invitation to health risks, rural areas have 20 percent fewer primary care physicians. Rural counties often do not have a psychiatrist to deal with mental health needs, and 81 percent do not have a psychiatric nurse practitioner.

LOSE THE IMAGE OF A WHITE FARMER ON A TRACTOR

Rural America’s needs are a bi-partisan issue impacting blue and red states. Congress has prioritized the rural communities’ needs for many good reasons.  People of color – often the most vulnerable in the health system – comprise 24 percent of the rural population. This includes rural Indigenous Americans and more than half of impoverished Black Americans. That compares with 18 percent of rural whites.

While politicians look for fixes to the problem, physicians, payers, private citizens and retailers are stepping forward to help address the care in access and quality gap.

Earlier this year, Walmart and Medscape released Healthcare Professionals’ Perspectives on Healthcare in Rural America, the most extensive survey to assess barriers and solutions to care delivery from the perspectives of professionals on the front lines of health care in rural and non-rural communities. More than 10,000 primary care health care professionals (HCPs) shared opinions that quality care is the most significant concern in their day-to-day efforts for their communities, particularly for people with chronic care and mental health concerns.

FORGET TECH – THE GAP IS ABOUT QUALITY CARE

Rural healthcare professionals are already utilizing telehealth and tapping into electronic medical records to improve quality care delivery. While there is plenty of buzz about remote patient monitoring and digital health technologies as tools that will enhance access to care, the biggest concern among physicians on the frontlines of addressing patient needs is clinical training and financial assistance to keep community hospitals operating. 

Physicians cite building on what they already utilize to care for their remote patients: state-of-the-art medical equipment, 5G internet service, and expanding use of electronic health records to guide their patients on self-care strategies. While technology helps with a care connection, it can only measure and monitor the substandard status quo.

PHYSICIANS IN RURAL AMERICA SEEK UPSKILLING

“We have known the systematic problems within the current health care system for decades. The Walmart-Medscape report emphasizes how health care professionals, like their patients, are most concerned about the quality of care, and we can no longer wait for old models to work,” said John Whyte, Chief Medical Officer at WebMD and Medscape and a Medika Life contributor. “This underscores the need for innovative solutions that look beyond the walls of the doctor’s office, similar to how Walmart is innovating in the space, driven by those who live and work in communities they serve.”

Often people in rural communities want to be cared for by people they know and trust and understand their local challenges and needs where they live and work. Experts addressing rural health needs know that staying well requires additional components beyond a physician visit.  The advocates seek to tackle social determinants of health, improved clinical care, and environmental factors.

Retailers like Walmart are partnering with health plans, advocacy groups, and third-party health associations like the American Heart Association to fill these gaps. Major retail pharmacies such as Walgreens are showing commitment by investing in efforts to address health drivers such as food insecurity, maternal and infant health, diabetes and hypertension solutions to reduce health disparities.

PRIVATE CITIZENS SEEK TO TRANSFORM RURAL COMMUNITIES

“Challenges to rural Americans cause suffering, which drives despair and feeds discord. Dialogue that elevates awareness of people’s difficulties is an important step in providing a remedy, and communication is the first step in providing viable solutions,” said Peter Finn, who founded, with his wife Sara Finn, a Foundation to address the pressing needs within his Upper New York State community of Hunter. Finn taps communication and creativity to make a difference and transform rural communities.

“I have been a long-time resident of Hunter, one of the far too many rural communities struggling in Upstate New York. The town was economically depressed and quickly deteriorating, but rather than abandon Hunter and shut our eyes to what was happening. We chose to get involved by raising awareness and mobilizing others to create the Catskill Mountain Foundation,” he adds. 

The Foundation calls upon the arts – music, creativity and dance – to draw people into the community all year round. Today, Hunter’s streets are lined with inns, restaurants, antique shops, and art galleries. Visitors come to enjoy the fall foliage, hike, and ski. The example of Hunter, New York, and other living laboratories proves how volunteering spirit, creativity and caring about rural community needs can shift the tide of events.

Others are contributing their talents to give voice to the diverse challenges rural Americans face.  “Living in the heartland has become increasingly difficult for Americans, and with this unprecedented narrative podcast documentary, we will present noted policy, community, and industry leaders working to change this reality,” reflects Matthew Zachary, co-founder and executive producer of the award-winning podcast network of OffScrip Health. 

Zachary, who is no stranger to tackling life-threatening issues, is looking to create the first audio documentary on the struggles of rural Americans, tapping into the network of companies, rural community leaders and government leaders who want to share how they are shifting from rehashing old issues to rolling-up their sleeves to solve problems.

CONFRONTING STIGMA – MENTAL HEALTH IN RURAL AMERICA

People with mental health needs face stigma.  That remains among the biggest hurdles to seeking care – the thought of “What will people think?” For people in rural communities, anticipating the negative reactions of family and community is an added emotional challenge that keeps people from seeking the care needed. Like any illness with progressive influence, failure to treat mental illness has life-threatening possibilities. Suicide rates increase as population density decreases. According to the Centers for Disease Control, suicide rates among people living in rural areas are as much as 68 percent higher than in large urban areas.

Jeff Winton is the Founder and Chairman of Rural Minds, a nonprofit organization working to end the suffering, silence and stigma surrounding mental illness in rural America. He is a part of the multigenerational farm Wall Street Dairy, LLC — a working dairy farm in Chautauqua County, New York – and founder of a major communications firm that addresses health issues.

In his opinion piece appearing on the National Alliance on Mental Illness (NAMI) website, Winton writes:

“Increasing awareness that mental illness is a health condition — just like cancer, heart disease, or diabetes — is one way to help overcome the stigma in rural communities. In addition, talking openly with others about lived experiences with mental health challenges helps to normalize the conversation and diffuse the stigma surrounding mental illness. The simple act of sharing stories can be an important first step for people to seek help for their own mental health challenges and encourage others to admit that they are struggling.”

The physical and mental health challenges to rural Americans cause suffering, which drives despair and feeds discord. Dialogue that elevates awareness of people’s difficulties is essential in providing a remedy, and awareness is a crucial step toward viable solutions.

OVERCOMING DESPAIR, DISEASE AND DEATH

Apathy and poverty double team are the domino of rural health killers. Walmart and Walgreen, and other major retailers are engaged.  Individuals with passion are leaning into the challenge and inviting others to join in their efforts.  Health organizations such as the American Heart Association, American Telemedicine Association, Blue Cross Blue Shield, National Rural Health Association, and many others have joined the effort to raise quality and ensure access to care.

Rural America is vast, with a remarkably diverse population and needs. The biggest problem isn’t decision-makers’ willingness to dedicate money or their readiness to align blue and red forces in bipartisan action to the challenge. The government often seeks big solutions to significant challenges.  However, the image we have long held onto of rural America – the proud and industrious farmer in a ballcap sitting on a tractor – is as outdated as the stoic, proud tiller of the land.  These citizens need our help urgently.  How do we resolve these problems? We start by recognizing that a one-sized solution does not fit all.

Woody Guthrie, while some verses of your ballad were conveniently edited out, we know your question:

As they stood there hungry, I stood there asking,
Is this land made for you and me?

Yes, it is!  Woody, we still remember.

The post Rural America – A Generational Struggle for Health Equality appeared first on Medika Life.

1. Convenient and accessible healthcare.

With telemedicine, patients can consult with their doctor or other healthcare provider from the comfort of their own home or office, without having to travel to a healthcare facility. This can be a major benefit for those with busy schedules or who live in rural or underserved areas.

2. Improve patient outcomes.

Studies have shown that telemedicine can help to improve patient outcomes, especially when it comes to chronic conditions such as diabetes and hypertension. This is because telemedicine can help to ensure that patients are receiving the care and treatment they need on a regular basis.

3. Reduce healthcare costs.

Telemedicine can also help to reduce healthcare costs by reducing the need for travel and overnight stays in hospitals or other healthcare facilities. In addition, telemedicine can help to improve the efficiency of care by reducing paperwork and administrative tasks.

4. Environmentally friendly.

Telemedicine can also be beneficial for the environment, as it reduces the need for travel, which can lead to fewer emissions of greenhouse gases.

5. Save lives.

Telemedicine can also help to save lives by providing access to care in emergency situations and by enabling early diagnosis and treatment of serious health conditions, that may otherwise get lost in the long and convoluted path to care.

But there’s something else that goes beyond the “boiler plate” platitudes for digital health. The reality is, and most miss this, is that telemedicine the very conduit through which healthcare innovation flows. It’s not just a simple tech to be implemented in a hospital system, but the very proving grounds for new digital health technology. The digital platform of telemedicine is an an electronic vascular system that readily assimilates many viable and powerful tools. The role of AliveCor’s ECG, EKO’s digital stethoscope, Butterfly’s hand-held ultrasound device, and a host of other health tech innovations are perfect tools to advance telemedicine to telemedicine 2.0 and drive real change — as a function of telemedicine adoption and advancement!

And that’s why telemedicine is critical to both healthcare and the digital health movement itself. It’s a fundamental partner in the advancement of tech-drive healthcare and works hand and glove in providing the shortest distance to success.

Digital health and telemedicine are two of the most important aspects of healthcare in the 21st century. Together, they offer the potential for many new technologies and innovations that can improve the quality and accessibility of healthcare for patients around the world. It’s short-sighted to see the emergence of telemedicine as just another option for an office visit. The reality is that telemedicine itself can be the direct underpinning for many digital health advancements. Further, this dynamic can facilitate adoption by leveraging the general social and clinical acceptance of telemedicine.

Telemedicine isn’t an option; it’s an imperative.

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