Telehealth Series: Fighting Rural Health Inequities with Technology

In late 2015, Wisconsin became the 12th State to adopt the Interstate Medical Licensure Compact (IMLC). This program recognizes that medical training is fairly uniform across the states involved, and it provides a quicker path to licensure for physicians looking to practice medicine in Wisconsin. The move for Wisconsin to enact the IMLC also presents a major development for health care delivery. Awarding out of state physicians medical licenses in an expedited process opens the door to patients receiving care at a distance and encourages the development of alternative methods of treatment such as telehealth.

In recent years, a physician shortage has become a topic of interest among health care industry leaders. The negative effects of dwindling cre is clearly demonstrated in rural communities, where less patients exist to subsidize overhead costs, throughout the United States by statistics such as an 8 percent increase in the rate of tooth loss due to decay in rural areas and disproportionate rates of suicide among rural residents; but is this because fewer physicians are available or is it an instance of geographic maldistribution? Data collected by Health and Human Services and analyzed by American Action Forum points to a prevalence of 2.6 doctors per 3,500 people, meaning an adequate supply of physicians is available in the U.S. The issue lies in location since doctors typically practice within urban and urban adjacent areas, leaving major swaths of the country without proper care.

In The Commonwealth of Virginia, only 11 out of the 133 independent cities and counties were free of Medically Underserved Areas, according to the Health Resources and Services Administration. Having such a wide area without relatively easy access to healthcare demonstrates a major flaw in the U.S. Health Care System. In order to provide better health services to patients, the areas of quick access must be expanded.

One solution that would ensure expanded access to healthcare is increasing telehealth utilization. As an already existing means of delivering health services, expanding the participation in different Telehealth outlets can combat misdistribution of health care. According to Bob Wolverton of the University of Wyoming’s Center for Rural Health Research and Education “the [Wyoming] state Medicaid office strongly supports providing distance care because it brings treatment to patients sooner…” Quick access to quality health care is important when considering the treatment of potentially life threatening conditions.

In the 2008, 40 million hospitalizations could have been avoided if proper care had been taken at an earlier stage. According to Agency for Healthcare Research & Quality, rural hospitals had a unnecessary hospitalization rate of 16 percent. In order words, patients with

less serious conditions were hospitalized instead of other (cheaper) methods of delivery treatment. This is an egregious waste of health care capital, considering these conditions were primarily diabetes and heart condition related. Especially for these conditions, Telehealth proves incredibly useful in the treatment and management of chronic conditions. It allows face-to-face contact with the physician managing a patient’s case on a regular basis, without forcing a patient to venture to a physicians office. By offering care from any location, preventable factors detrimental to public health may be negated.

Following the Office of Veteran’s Affairs implementation of their Care Coordination/Home Telehealth program the rates for hospital admission due to complications from diabetes fell by 20 percent while depression dropped by 56 percent and incidences of hospitalization for other psychiatric disorders fell by 40 percent. Data that has been collected on telehealth services demonstrates its efficacy as a means of delivering healthcare and providing preventative services. This use of technology brings the physician into the home of the patient and allows for both increased access to care and better management of overall treatment.

In an era run by technological innovation and advanced communication, integrating telecommunications into the medical field is imperative. Considering the current state of health care in the U.S., increasing access to health care for those out of its traditional reach should be on the forefront of health care policy. In order to better serve the recipients of care in the U.S., alternative methods must be implemented. It is illogical to assume that all individuals in need of health services exist within the same means and therefore need identical types of health care delivery. Diversifying the methods of patient-physician interaction ultimately raises the number of individuals who have the ability to maintain their own health. Increasing access to health care in a sustainable manner will benefit American people, creating a more efficient and, healthy society.

Wisconsin’s adoption of the IMLC bolsters the movement towards using telehealth as a means of fighting geographic maldistribution of health care services, but it isn’t enough. There need to be changes in both financial and regulatory legislation that promotes expansion of telehealth. By expanding reimbursement for telehealth services and decreasing the red tape required to obtain medical licenses in multiple states the reach of telehealth will be increased and access to services expanded.