1、Narrowing the rural-urban health divide Bringing virtual health to rural communities A report from the Deloitte Center for Government Insights The Deloitte Center for Government Insights (DCGI) shares inspiring stories of government innovation, looking at whats behind the adoption of new technologie
2、s and management practices. The center produces cutting-edge research that guides public officials without burying them in jargon and minutiae, crystalizing essential insights in an easy-to-absorb format. Through research, forums, and immersive workshops, the goal of the center is to provide public
3、officials, policy professionals, and members of the media with fresh insights that advance an understanding of what is possible in government transformation. To learn more about DCGI and its research, please visit D. About the Deloitte Center for Government Insights Deloitte Consultings Virtual Heal
4、th practice helps clients assess the transformative opportunities that can be possible through the use of virtual health, determines which capabilities would best serve their customer or patient populations, and aligns potential solutions to their strategic imperatives. Our work helps health care or
5、ganizations build a scalable virtual health program that fits their needs, deploys strategic capabilities, and aligns capabilities to care delivery pathways. Our practice brings insights from leaders across the industry with experience in strategy, operations, human capital, technology, and a founda
6、tion in clinical and operational experience. Alex Schulte | Alex Schulte is a practitioner in the Commercial Strategy and Operations practice at Deloitte Consulting. She has worked with providers and plans, focusing on population health and care management strategy, design, and implementation. Melis
7、sa Majerol, MPH | Melissa Majerol is a health care research manager with the Deloitte Center for Government Insights. She supports the Deloitte Government and Public Services practice with her research and comprehensive policy analysis in areas including Medicaid, health reform, emerging technology,
8、 and value-based care. She is based in Washington, DC. Jessica Nadler, PhD | Jessica Nadler is a health care strategy leader in the Government and Public Services practice at Deloitte Consulting. She focuses on data-driven transformation to improve access to and experience of quality health care. Na
9、dler resides in Washington, DC. Connect with her on LinkedIn at www.linkedin. com/in/jessica-nadler-b157294/. About the authors Contents Executive summary 2 Virtual health 4 How can virtual health help rural communities? 6 Planning and implementing a virtual health program 9 How government can help
10、15 Conclusion 17 Appendix 18 Endnotes 21 2 Access to health care ranks among the top challenges facing rural communities today due to provider shortages, long travel distances, and the acceleration of hospital closures in recent years. While not a panacea, virtual health can address many of these is
11、sues, and in turn, help narrow the rural-urban health dividethe stark disparity between access to care and the overall health of citizens in rural areas compared to their urban counterparts. Executive summary I N THIS REPORT, we lay out some of the key steps rural health care organizationsincluding
12、critical access hospitals, federally qualified health centers, rural health clinics, and tertiary care facilitiesshould consider when delivering virtual health in rural settings, and what government can do to support and enable rural communities in this capacity. Our analysis is based on interviews
13、with more than a dozen rural health care experts and reviews of secondary literature. Below are six key steps leaders of health care organizations should consider as they build their virtual health programs: Conduct a needs assessment. Before starting a virtual health program, leaders should conduct
14、 a needs assessment of the organization and the population it serves to identify the most appropriate virtual health solutions, current technological capabilities, future technological needs, and how to bridge the gap. Develop a strategy, governance structure, and partnerships. Having a coordinated
15、strategy and a centralized governance structure within the health care organization are critical to the success of any virtual health program. In addition, organizations should build partnerships and networks with other entities. Invest in data and technology infrastructure. Hardware and software in
16、vestments are core to any virtual health program, but health care organizations should also pay attention to interoperability and investments that should be made in cognitive technologies and analytics. Engage with and train your workforce. Making virtual health a mainstream aspect of rural care wil
17、l require significant buy-in from and investment inthe health care workforce. To help win over key stakeholders, leaders can emphasize the benefits to patients and clinicians and teach the workforce to use the new technology. Create new workflows, care models, and risk mitigation protocols. Virtual
18、health should be integrated into a seamless and coordinated delivery process across different providers, services, and settings. Engage with and educate patients. Just like clinicians, patients should be educated on the benefits of virtual health, and how to use the new technology. Narrowing the rur
19、al-urban health divide 3 While health care organizations will need to take the lead, they wont be able to do it alone. In order to see the potential of virtual health realized, public and private organizations should work together to align incentives, leverage scarce resources, share best practices,
20、 and create economies of scale. The role of government is critical as well. By helping to build connectivity, simplifying the process of applying for funding, and driving the adoption of value-based care, government agencies can enable and support rural communities as they use virtual health to help
21、 bridge the rural-urban health divide. Bringing virtual health to rural communities 4 Virtual health The opportunity for rural communities M ARTINA WAS BORN in a hospital in rural Nebraska. Shortly after her birth, her doctors detected a pneumothorax, or collapsed lung. Neonatal events like these so
22、metimes require an intervention; other times they heal on their owna call that a neonatal specialist needs to make. But this rural hospital wasnt equipped to handle rare conditions such as the one Martina was experiencing, and no such specialist was on hand. The standard protocol would have been to
23、put Martina in a helicopter and transport her to the nearest tertiary care facility, more than 150 miles away, so that a specialist could assess whether an intervention was, in fact, needed. Luckily, the local hospital had just joined a virtual hospital service: Martinas parents were given the optio
24、n to have a remote neonatal intensive care unit (NICU) physician monitor the newborn via two-way video conference. They chose this option. As a result, Martina was able to fully recover with very little treatment, and has grown into an active and healthy toddler. Her parents were able to stay in the
25、ir community with their three other children, rather than being separated from their newborn and having to travel long distances each time they went to see her in the NICU. And thousands of dollars were saved in helicopter transfer costs.1 This story is emblematic of some of the challenges facing ru
26、ral communities, and how virtual health could improve health care access for rural residents. Virtual health services can also offer important benefits to the health care system more broadly: the opportunity for rural clinicians to learn from specialists, and for rural hospitals to retain vital reve
27、nue and enhance the quality of their services. Moreover, a growing number of studies have shown that virtual health can improve health outcomes, reduce costs, reduce unnecessary utilization (such as nonurgent visits to the emergency room), improve adherence to medication and other protocols, and imp
28、rove patient satisfaction. (See the appendix for a summary of studies documenting the impact of virtual health.) WHAT IS VIRTUAL HEALTH? Virtual health refers to the delivery of health services in a way that is independent of time or location using enabling technology, such as video conferences, mob
29、ile apps, in-home sensors, text-based messaging, and analog telephones. Virtual health visits can take place between a patient and his/her clinician, or between clinicians. But virtual health goes beyond video conferences (synchronous visits) to include remote patient monitoring, email/telephone com
30、munication, and store-and-forward technology (asynchronous visits, in which data such as MRI scans or photos of a rash are captured and sent to medical professionals via a secure and encrypted internet connection). With applications designed to drive connected, coordinated care, virtual health can c
31、omplement, or substitute for, in- person care as appropriate (figure 1). These applications present a critical opportunity for rural areas to receive improved access to care. Narrowing the rural-urban health divide 5 Source: Deloitte analysis. Deloitte Insights | FIGURE 1 Virtual health applications
32、 drive connected, coordinated care How virtual health applications can help stakeholders access data more easily, improve quality of care, and deliver value to patients COMMON APPLICATIONS OF VIRTUAL CARE DELIVERY Synchronous care to improve patients ease of access to providers Physician-2-physician
33、 communication to improve patient care through information-sharing Chronic disease management to improve monitoring and alerts for chronic disease patients Virtual social work to improve communication and care for underserved populations Tele-health care to improve disease monitoring (e.g., eICU, te
34、lepsychiatry, telestroke) Remote patient monitoring to improve providers understanding of patients health and medical data Care management process to improve patients understanding of and engagement with their treatment plans Patient adherence to improve medication adherence, health tracking, and pa
35、tient accountability Care coordination to improve payer/provider relationships Bringing virtual health to rural communities 6 How can virtual health help rural communities? A MONG THE MANY issues impacting rural America, access to health care and related health disparities rank among the top (figure
36、 2). A recent spike in hospital closures has exacerbated these issues, as more health care professionals in rural areas already experiencing provider shortages have left to find jobs elsewhere. This has resulted in many rural residents needing to travel even longer distances to receive care, and has
37、 increased access barriers to both specialty and primary care because hospital emergency departments are a major source of primary care in rural communities.2 Among the hardest hit have been elderly and low- income populations; both are more likely to delay or forego needed care because of transport
38、ation challenges. Whats worse, the trend in rural hospital closures is expected to continue.3 Virtual health has been identified as one part of a suite of new health care models that could help address rural health needs and narrow the rural-urban health divide. Virtual health has been around in som
39、e form for decades. However, due to advances in digital technologies,4 an increasingly supportive policy landscape,5 and a growing evidence base showing its effectiveness (see appendix), implementing it now makes more sense than ever. Nevertheless, successful implementation of virtual health into ma
40、instream health care systems has been slow. There are several forms of virtual health that can be used in lieu of, and in addition to, in-person visits to alleviate various rural health challenges, including provider shortages, and time, distance, and transportation barriers. These include virtual v
41、isits, store-and-forward technology, and email/ telephone communication (see sidebar, “What is virtual health?”). Virtual visits can be used to address specialty provider shortages by connecting groups of community providers with specialists at centers of excellence in real-time sessions. This allow
42、s specialists to share their medical knowledge and expertise with on-site clinicians, helping them diagnose and determine a course of treatment for a patient. Finally, health care organizations can use remote patient monitoring (RPM) to track the vital signs of people who require chronic, postdischa
43、rge, or senior care, allowing them to keep track of patient data between visits and intervene with medication adjustments or other treatment recommendations before a patient requires urgent medical attention. Using virtual health as a preventive care tool can help reduce the number of unmonitored ch
44、ronic conditions that become urgent episodes. Given that rural areas have a higher prevalence of chronic disease,6 RPM can be especially effective at preventing adverse events and maintaining continuity of care in these settings. Virtual health can also help rural residents maintain privacy and conf
45、identiality, while overcoming the stigma associated with certain health conditions. In small, tight-knit communities, individuals with a behavioral health condition may know the local behavioral health specialist personallyif their community is lucky enough to have such a specialist. Some may be rel
46、uctant to seek help for their condition because of privacy and confidentiality concerns, and due to the stigma still often associated with these Narrowing the rural-urban health divide 7 conditions. The ability to receive treatment from a professional outside the community may encourage an individua
47、l with these needs to seek care.7 Rural patients who have tried virtual health generally report high satisfaction. According to a recent survey of life in rural America, one- quarter (24 percent) of rural adults have used FIGURE 2 A snapshot of rural and urban America: Population characteristics and
48、 leading health indicators8 Rural (nonmetropolitan) Urban (metropolitan) Population characteristics Population (% in 2015)914.385.7 People aged 65 and over (% in 2017)1018.114.3 Household income (median in 2014)11US$43,616US$58,229 Access to care Primary care physicians per 10,000 people (2014)1258
49、Total physicians per 10,000 (2014)131333 Percentage saying access to good doctors and hospitals is a major problem in their local community (2018)14 2318 Longest average drive time to the nearest hospital, in minutes (2018)15 3418.7 Health status Diagnosed diabetes prevalence (% in 2016)1612.69.9 Obesity prevalence (% in 2016)1733.528 Preventable hospitalization (hospital stays for a
sgpjbg002
工作日 9:30 - 18:00
会员动态：
报告分类
新质生产力
ChatGPT
新能源汽车
大模型
Sora
机器人
微短剧
芯片
薪酬
白皮书
低空经济
数据要素
创新药
人工智能
AI产业
信息科技
互联网
消费经济
汽车交通
电商零售
传媒娱乐
医药健康
投资金融
能源环境
地产建筑
传统产业
英文报告
其它
扫码登录
手机快捷登录
账号登录
