Dr. Shirisha Avadhanula from the Cleveland Clinic explains the inherent equity issues of our current system, and addresses what we can do to make it work better for everyone.
Shirisha Avadhanula, MD
Medical Director, Inpatient Virtual Health
Cleveland Clinic
Shirisha Avadhanula, MD, serves as Medical Director for inpatient virtual health for the Cleveland Clinic Enterprise and is an associate Staff Endocrinologist at the Cleveland Clinic in Cleveland, Ohio. She is also a Clinical Assistant Professor of Medicine in the Cleveland Clinic Lerner College of Medicine. Dr Avadhanula is also the co-founder and CEO of Whitecoatremote.com and senior consultant for Dr.A1c.com.
What are the discrepancies between our healthcare spending and healthcare system performance?
If we look at the United States from a global perspective, we spend more money on healthcare than any other developed country on the planet. In 2021 we spent $4.3 trillion—that’s about $12,000 per person that year—but our health outcomes are the poorest.[2]
The reason we see this discrepancy is because the healthcare system, as it stands today, is designed to easily accommodate only the most connected. The patients suffering the most, and who need healthcare the most, are being underserved.
What is the health impact on those in underserved populations?
What we see at our organization is that individuals in underserved communities have higher rates of chronic diseases, cardiovascular disease and diabetes—all of which can lead to end organ complications. Overall, patients from underserved communities have poorer outcomes. It’s important for organizations like ours to focus on these communities and to help fill these gaps in care. For us here at the Cleveland Clinic that certainly involves using digital tools to positively impact this patient population.
Rural residents were found to have poorer health, with rural areas having difficulty in attracting and retaining physicians and maintaining health services on a par with their urban counterparts.[3]
What does it mean to increase access to care?
Access is such a broad term and is largely attributed to “entry into the medical system.” But, of course, there’s much more to it: it’s one thing to implement a digital health tool, for example, and quite another to also ensure patients have access to reliable internet and have the digital literacy to use the tools. When I think of increasing access through digital health, organizations need to also make sure they are educating the patients and providers on the technology for the best possible outcomes.
As we move forward, we have a responsibility to come together both in the academic and private healthcare sectors to innovate for those who would benefit from the system the most.
Cleveland Clinic had around 14% of providers using digital tools to serve our outpatients before the pandemic. After May 2020, 95% of provider use digital tools.[4]
TeladocHealth.com | engage@teladochealth.com
1 Orminski, Emily. “Your Zip Code is More Important than Your Genetic Code.” June 30, 2021. National Community Reinvestment Council.
https://ncrc.org/your-zip-code-is-more-important-than-your-genetic-code.
2 American Medical Association. “Trends in health care spending.” Updated March 20, 2023.
https://www.ama-assn.org/about/research/trends-health-care-spending.
3 Douthit, N., Kiv, S., Dwolatzky, T., & Biswas, S. (2015). “Exposing some important barriers to health care access in the rural USA.” Public Health, 129(6), 611–620. doi: 10.1016/j.puhe.2015.04.001.
At the Becker's 11th Annual IT + Revenue Cycle Conference: The Future of AI & Digital Health, taking place September 14–17 in Chicago, healthcare executives and digital leaders from across the country will come together to explore how AI, interoperability, cybersecurity, and revenue cycle innovation are transforming care delivery, strengthening financial performance, and driving the next era of digital health. Apply for complimentary registration now.
