Telehealth a good fit for rural population health management and engagement

Rural populations pose a unique challenge and opportunity for hospitals and health systems.

The main challenge being simple geography – the average distance between them and their patients is farther away. There are also health disparities between urban and rural populations, which can make managing these patients more difficult.

Expanding care access, while the right thing to do, comes at a cost, so it must be conducted strategically and efficiently. Many healthcare organizations in rural areas are finding video-based telehealth services integrated with a mobile-focused population health management strategy “shortens” geographical distances while cost-effectively expanding access and improving engagement and outcomes.

By automating simple, but highly personalized outreach and interactions with patients through mobile and offering video-based telehealth services, organizations can motivate rural patients to act in-the-moment, and give them the ability to initiate their own provider interaction, saving healthcare professionals time and enabling them to scale quality services across broader markets.

Rural healthcare needs are extensive
Although rural populations pose logistical and financial challenges to providers, these regions have significant needs. For example:
• Rural areas have more frequent occurrences of diabetes and coronary heart disease than non-rural areas
• Nearly 20 percent of adults describe health status as fair or poor, compared to less than 16 percent in urban areas2
• Rural youth are twice as likely to commit suicide.3

To treat both physical and behavioral health conditions, patients in rural communities often face hours of travel and potentially time away from work, both of which add to their personal costs. This is especially the case for consultations from specialists where there are 30 such physicians per 100,000 residents in rural areas, compared to 263 specialists per 100,000 residents in urban areas.4

Rural populations independent and community focused
Despite these disparities, rural populations tend to be less inclined to visit a healthcare provider, not due to greater skepticism of healthcare, but more so due to tradition and trust. With a history of being isolated from urban areas and services, rural areas have tended to look within their own communities to solve challenges, including healthcare. Living in a rural area also requires people to be independent and self-sufficient.

Trust is another major factor. Urban and suburban populations are more accustomed to faster, market-driven growth in their neighborhoods, resident influx and new businesses and companies opening their doors. Since rural communities are tight-knit and less accustomed to change, establishing trust is more challenging, especially for healthcare organizations.

To demonstrate their dedication to patients in the area and help build that trust, it is essential for healthcare organizations to offer highly targeted and personalized communication, information and care services to designated patient populations. Presenting care access in this way forges a patient-provider relationship while helping patients manage their health and eliminate the travel challenges associated with seeking care in their area.

Essential components of a telehealth-integrated engagement plan
While patients may have commonality in their chronic conditions, each patient profile is unique. Additional factors including family health history, comorbidities, circle of support, condition knowledge and treatment plan-adherence commitment should be factored in to promote positive health and wellness decisions and enable ongoing engagement that is effective for each individual.

To ensure optimal adherence, principles of BehavioralRx™, are applied to leverage a behaviorally-based scientific approach to first connect and build trust and credibility with the patients. These cognitive and behavioral methods establish the belief that the telehealth resources provided will further patients’ health and wellness and credibility that by following directives, patients will not be put in harm’s way and their outcome will be positive. Once achieved, condition-specific and wellness education must be delivered in easy to follow “snackable bites” at the right moments throughout the day, with timings and delivery of resources triggered through automated mobile surveys and ongoing bi-directional feedback and assessments with patients. Based on responses to automated outreach, organizations can then create a path for patients to take immediate action, such as scheduling appointments, filling prescriptions, or requesting a live provider encounter through a video-based online visit. This on-demand access to live providers is another motivator that encourages engagement with the treatment plan. This highly personalized and customized approach motivates patients to more effectively self-manage their conditions.

Not only are on-demand telehealth encounters from a remote setting convenient, but they can potentially save patients in rural areas the travel, costs and disruption to their schedule. Delivering care and boosting engagement through mobile and telehealth can also alleviate the healthcare organization from opening a new brick-and-mortar facility or adding staff, which saves costs without sacrificing compassionate, high-quality care to patients who need it.

Expanding care access to rural areas can be a challenge. When done correctly, however, using a highly personalized strategy that creates a nurturing experience within a patient’s lifestyle, it can drive satisfaction across rural populations and establish the trust that is so crucial between patients and providers.

About the authors:
Bob Gold, who started and owned an organic farm in a rural area in New Jersey, is founder of Gold Group Enterprises. Shelley Schoenfeld grew up in Kingston, PA, population ~12k, where it wasn’t uncommon to make trips in excess of 2 hours to access specialized healthcare. Shelley is Chief Strategist, GoMo Health, focused on creating engaged solutions to support remote healthcare delivery.

Tom Toperczer is director of product management for Brother. With more than 20 years of experience in the video conferencing industry, Toperczer supports the company’s OmniJoin division that develops video web conferencing solutions with a growing healthcare segment.

1 National Rural Health Association. “About Rural Health Care” Web page. Accessed May 7, 2018. https://www.ruralhealthweb.org/about-nrha/about-rural-health-care#_ftn1
2 Ibid.
3 Ibid
4 Ibid.

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