Michael Morgan

How telehealth is improving outcomes for patients in rural and underserved populations

November 13, 2020
By Michael Morgan

For many years, a substantial gap has existed between mainstream and underserved populations -- including minorities and individuals residing in rural or low-income communities -- when it comes to access to care and the latest healthcare technology advancements.

There are several challenges facing vulnerable populations, including limited transportation options, lack of health insurance coverage, poor health literacy, social stigmas and privacy concerns -- to name a few. These challenges can create large healthcare problems. In fact, a 2014 study found that an estimated 3.6 million Americans miss at least one doctor’s visit a year because of transportation issues, and underserved populations are at a greater risk for chronic disease.

Since the COVID-19 pandemic, the spotlight on these inequalities has only shone brighter. A lack of access to resources has made it increasingly difficult for vulnerable populations to receive evaluation, testing and treatment for COVID-19 and they have been disproportionately affected by the virus.

Virtual care has the potential to help close the gap for underserved populations. Just as wireless phones leveled the playing field for people living in remote areas which lacked traditional telecommunications infrastructure, virtual care is leveling the playing field for patients by enabling access to care through a mobile device or laptop - rather than through a traditional brick and mortar doctor’s office. However, in order to ensure all patients have permanent access to care and improve health outcomes for individuals in underserved communities, we must equip our health systems and providers with the technology to treat patients regardless of where they are.

Reducing the gap in real-life: Telehealth in North Carolina clinics
The North Carolina Association of Free and Charitable Clinics (NCAFCC),a nonprofit organization dedicated to improving the health and well-being of the uninsured and underinsured in North Carolina, has addressed this issue head-on. Comprised of 68 member clinics and 87 clinic sites throughout the state, NCAFCC serves under the mission that the medically underserved should have access to affordable, quality healthcare.

Prior to COVID-19, only a few of its clinics were leveraging telehealth. When COVID-19 hit, the need for direct primary care via telehealth increased significantly and Randy Jordan, Chief Executive Officer, NCAFCC knew immediately that the clinics needed a safer, more efficient way to keep both patients and providers safe. NCAFCC instantly began training several of its member clinics who wanted to participate. Within just two weeks, NCAFCC had around 40 member clinics fully trained and actively engaging in telehealth.

The use of telehealth proved to be transformational for the clinics and its patients. At the height of COVID-19, telehealth allowed NCAFCC to safely keep the practices open to care for uninsured patients. Many clinic leaders said they would not be open without the technology. With telehealth, they were able to see patients remotely before they came into the office and continue offering care to individuals in the local communities. This was especially important when triaging potential COVID-19 patients during the period from March 1 through August 31, 2020; about 3,300 patients were suspected to be COVID-19 positive, and 1,280 were confirmed. Telehealth has also supported new patient engagement, with the clinics gaining 7,800 new patients so far this year -- a 10.6% increase.

Efficiency has also gone up, with “no-show” rates dropping for one clinic from 15% to 8% when using telehealth. This highlights how easy the technology is to use and how convenient it is for patients. Since the start of COVID-19, several of the NAFCC clinics are now 100% virtual, leveraging telehealth as the primary mode of care. In these clinics, telehealth has become an integral part of their patients' care plan.

Leveraging telehealth to improve health outcomes during COVID-19 and beyond
Since the pandemic, telehealth has enabled physicians to provide ongoing care without patients ever having to leave their home, helping to bridge the gap for underserved populations. However, there is still work to be done. While telehealth has been an effective tool in treating underserved populations, many still do not have access. In fact, recent study shows that while there has been unprecedented expansion in telehealth this year, minorities, including Black and Hispanic patients, still have lower odds of using telehealth versus either the ER or an office visit than either Whites or Asians – which remains true even after adjusting for age, comorbidities and preferred language.

Moving forward, ensuring all patients have awareness of and access to virtual care will be critical to closing the gap on healthcare. As providers look to integrate telehealth into their practices, they should collaborate with a healthcare technology partner that can efficiently implement an entire virtual care strategy that leverages tools to support every step of a patient's journey - including video chat, secure text messaging and broadcast, electronic fax and forms and more. Additionally, the industry needs to remove barriers to adoption, provide a seamless, engaging experience and ensure permanent reimbursement of telehealth for all providers and patients.

About the Author: Michael Morgan is the CEO of Updox. With a successful track record in helping organizations use technology to transform the way healthcare is delivered, Mike has more than 25 years of healthcare leadership within software, behavioral health, and HIT organizations. Updox was named to the Inc. 5000 list of fastest-growing companies in America for the past six consecutive years.