When It Comes to Patient Access to Healthcare, Increasing Cloud Coverage Over Rural America Is a Welcomed Forecast
What if your family’s access to healthcare was dependent on your family’s access to broadband internet? For millions of people living in rural America, this isn’t a hypothetical scenario.
Roughly 8.6 million Americans live more than 30 minutes from a hospital. For them, broadband can serve as the main gateway to healthcare, providing the primary means for connecting with physicians, information, and resources that would otherwise be unavailable due to distance and isolation.
This depends, however, on their access to broadband, which is only available to 62.2% of rural Americans. As this FCC map shows, many counties have a double burden of having fewer physicians per capita than the national average and broadband access rates below 50%.
Broadband gaps have been closely associated with high rates of diabetes, obesity, and other chronic conditions that top the list of preventable deaths. A recent Centers for Disease Control and Prevention (CDC) study found that rural Americans are more likely to die from five potentially preventable conditions than their urban counterparts, including “25,000 from heart disease, 19,000 from cancer, 12,000 from unintentional injuries, 11,000 from chronic lower respiratory disease, and 4,000 from stroke.”
Combined, the lack of access to care and the prevalence of preventable disease is deadly. Many rural communities are left struggling to manage high-cost avoidable health events, drive effective prevention efforts, and retain clinicians. According to the Sheps Center, 172 rural hospitals have closed since 2005, with 13 of those (or 8 percent) closing in 2020. If closure rates continue at the level that they have been through the first half of 2020, this could be the highest year for rural hospital closures since the Center started tracking closure data, leaving many rural communities without a nearby hospital.
Increasingly, healthcare providers are relying on technology to counter the effects of this alarming trend. Each year more providers are turning to cloud-based healthcare IT solutions to extend the reach and increase the efficacy of patient care. According to a HIMSS Analytics survey of healthcare IT executives, many hospitals and other care organizations are deploying cloud-based software-as-a-service (SaaS) solutions for clinical applications and data hosting, among other uses. In fact, reliance on cloud in Healthcare IT has more than doubled since 2015.
And now with COVID-19, internet access to cloud-based healthcare IT solutions has proven to be a lifeline for hospitals and their patients. Telehealth, in particular, has seen a meteoric rise during the pandemic. While telehealth had gained modest traction within rural communities before this year, regulatory changes brought about because of COVID-19 have stripped away many of the barriers that, prior to the public health emergency announcement, had stood in the way of widespread telehealth adoption.
These temporary policy changes have made it easier for individuals enrolled in Medicare, Medicaid, and the Children’s Health Insurance Program (CHIP) to receive telehealth services at home. These changes also reduced technology barriers and increased reimbursement for telehealth episodes of care, thereby incentivizing providers to leverage this life-saving technology.
Funding efforts primarily drew from the Coronavirus Aid, Relief, and Economic Security (CARES) Act, which allocated $325 million for broadband infrastructure and telehealth initiatives. In addition, the Federal Communications Commission received $200 million to extend broadband access and telehealth adoption further into underserved areas. While gaps in broadband access remain, COVID-19 has accelerated broadband investment and outreach to rural communities.
The pandemic has also brought attention to the cost-saving potential of cloud-based SaaS solutions, as many providers lose revenue from elective procedures due to COVID-19 concerns. A 2015 study in the Journal of Healthcare Informatics Research found that SaaS EHR platforms “allow small and mid-sized hospitals, in addition to large-sized hospitals, to adopt information infrastructures and health information technology with low system operation and maintenance costs.” This is invaluable especially for rural hospitals, who were already running on tight margins before the pandemic and lack the IT resources of their larger counterparts.
At the same time, COVID-19 has underscored the challenges with on-premises, “one-size-fits-all” EHR solutions. While the industry has talked around the need to harness healthcare data, COVID-19 has put in sharp relief the need for alternatives to the established means for data delivery and integration, as highlighted by the recent Chilmark Research report, Open APIs in Healthcare: The Future of Data Integration.
Key among the report’s insights is the role that open application programming interfaces (APIs) have on unlocking value. SaaS-based EHR platforms enable easier integration with other applications through APIs, which can extend the capabilities of the core EHR and drive to a true system of clinical intelligence.
While there are still areas within the United States that are underserved by broadband, COVID-19 has, at a minimum, reduced barriers to expanded broadband investment. Perhaps more importantly, COVID-19 has brought the hardships endured by rural healthcare providers to the forefront of the healthcare conversation. By surfacing challenges to access, this pandemic has also highlighted the flexibility and power that cloud-based, SaaS EHR platforms can have in transforming data, enabling organizational agility, and ensuring connectivity between patients, providers, and the larger healthcare community.
And that’s anything but a hypothetical.