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Carving a Path Toward Healthcare Equity: The Surge of Public Investment in Digital Health


Patients in rural communities could benefit most from greater healthcare access. But challenges remain.

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Digital health funding is soaring and so too is the number of applications. Image has been edited. Licensed from XYZproject — stock.adobe.com.

Digital health is largely recognized for its broad application, adaptability and accessibility, and the healthcare industry continues to be laser-focused on its potential to reach patients, especially those in rural areas. Rural Americans face unique challenges, making it substantially more difficult for them to receive access to comprehensive, modern medical care.

Reasons for the challenges vary. Among the explanations is geographic isolation, a healthcare provider shortage, lack of acknowledgment from legislators, differing social and cultural beliefs on healthcare and serious financial constraints posed by the costs of medical care and services. The impact of these factors means that many of our nation’s population, especially elderly Americans — nearly 20 percent of whom live in rural areas — face significant hurdles to obtaining comprehensive medical care that is more readily available to Americans living in urban and suburban areas.

>> LISTEN: Rural Healthcare’s High-Tech Hope

Digital health services are rapidly being recognized as one of the best tools to address these pervasive public health issues facing rural Americans. As a result, a number of public agencies are paying close attention. For example, the Federal Communications Commission (FCC) is in the process of launching the Connected Care Pilot Program, which will fund a $100 million telehealth program. The FCC recognizes telehealth as being similar yet distinct from telemedicine. Telehealth refers to remote healthcare outside the scope of the doctor-patient relationship. These services include consultations with non-physician health professionals like nurses, pharmacists or social workers assisting patients with patient health education, social support and medication adherence. The collective term for this kind of healthcare is often referred to as digital health.

Public investment in digital health is a signal to states that this type of healthcare delivery will be a mainstay in the industry’s future. The FCC’s pilot program will support a number of digital health projects that aim to deliver healthcare services to low-income Americans in rural areas. The program also prioritizes veteran healthcare.

Patients can benefit from remote access to primary and specialty care services by using community health kiosks as centralized access points in public spaces, such as libraries and shopping centers. This method reduces the burden on patients, who could be deterred from using digital health services if they have to invest substantial time or money in the required technology. Many of the geographical areas in the U.S. still lack the infrastructure to support affordable broadband Internet, an increasingly critical part of modern American life.

Public comment on the FCC’s pilot program from healthcare and technological stakeholders includes a resounding push for foundational measures. In particular, broadband and healthcare providers ask the FCC to concentrate on building out existing connections.

The FCC’s focus may be on building up a solid internet infrastructure. However, a strong technological foundation is just one of several areas that demands attention to make digital health services a true reality for all Americans, including those in rural areas. Foremost are obstacles that providers and innovators face with licensure requirements. Traditional state regulatory models are often unsuitable for modern trends in medicine. Among the most significant barriers is the lack of clarity and uniformity among state licensing requirements. Delivery of care was, naturally, localized prior to the advent of digital health innovation. However, as state lines become increasingly less identifiable in the modern business world, medical licensure must also modernize.

Another barrier to the market of digital health services is the slow adoption of widespread reimbursement mechanisms. A comprehensive digital health program requires significant upfront investment in both technology and the organizational resources needed for adequate program building. A successful digital health program also requires patient trust. Patients must be able to rely on their ability to use these services without being charged exorbitant fees or receiving coverage denials. The reimbursement mechanisms employed for digital health services, both public and private, must subscribe to equitable and logical pricing, whether contractually or through legislative rulemaking.

Currently, there is public funding for limited telemedicine services. Without a clear and robust reimbursement structure, providers who are not affiliated with larger, expansive health systems may not be able to give their patients the full benefits that digital health has to offer.

The aggregate impact of these hurdles may deter providers who lack the access to the substantial upfront investment that digital health requires. While the federal government increases its investment in digital health services, legislative uniformity and industry understanding must follow. No matter how much money is poured into digital health programs, such as the Connected Care Pilot Program, there must be policy changes to the complex regulatory landscape so that digital health innovators and all Americans alike can realize the potential for this new mechanism of healthcare delivery.

The growth of digital health services can help address serious consequences facing our nation due to provider shortages. But proactive, patient-centered policymaking must be front and center in order to reach the goal of providing comprehensive, modern medical care to all Americans.

Roma B. Patel and Richard P. Steelman, Jr. are attorneys at the law firm Buchalter.

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