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At Health Evolution’s 2023 Connect, industry experts came together to explore the pressing challenges and opportunities in health care delivery in underserved areas. In our Big Discussion, “Preventing Rural Health Deserts: Cross-Industry Collaborations to Protect Access and Overcome Precarious Economics,” discussion leaders Kevin Ban, MD, former Chief Medical Officer, Walgreens Boots Alliance; Tommy Ibrahim, MD, former President & CEO, Bassett Healthcare Network; and Jennifer Schneider, MD, Co-Founder & CEO, Homeward, underscored the importance of addressing rural health care issues with a multifaceted and collaborative approach. Moderated by Vineeta Agarwala, MD, PhD, General Partner, a16z, the panel held a dynamic discussion where they shared their insights and specific recommendations, touching on telemedicine, regulatory reforms, innovative care models, and more. 

The Power of Telemedicine: Transforming Rural Health Care

Leaders recurringly stressed telemedicine’s pivotal role in addressing rural health care disparities and called on health care CEOs to expand access to telehealth. One executive attending the conversation advocated for telemedicine, stating, “I firmly believe it can be a replacement service. For a recent patient of mine, we did the preoperative care, the anesthesia care, the entire surgical workup virtually. I met the patient the first time face-to-face the day of surgery. I think it’s very important that we look at how we support rural care using telemedicine.” This striking example highlights the transformative potential of telemedicine for specialized medical conditions.

Echoing that sentiment, leaders emphasized the critical need to leverage telemedicine to enhance access to care in remote regions.

Ibrahim, reflecting on his experience, shared, “Three years ago, I faced resistance while advocating for virtual health in conversations with my medical staff. It took a global pandemic to motivate our physicians to opt in and adopt, resulting in a 10,000% increase overnight in virtual health utilization. This experience opened up a broader dialogue within our health system about leveraging technology to advance patient care and access.”

Agarwala also noted that technology can help organizations “direct limited resources to a small set of patients who stand to benefit from them most,” and added that organizations can “automate some fraction of the care delivery that we’re doing virtually.” For example, she said, “I’m a big proponent of SMS-based engagement. It’s one of our biggest innovations over the last five years in both urban and rural populations because of a lack of broadband access and because of consumer changes that are making us expect text messages from almost everybody that we interact with.” 

Embracing telemedicine and incorporating it into an organization’s strategic vision can revolutionize rural health care delivery, leaders said. Telemedicine offers a remarkable opportunity to reach underserved populations, improve access to care, and enhance patient outcomes. Committing to advancing telemedicine long term will not only improve health care in underserved areas, but also has the potential to reduce costs, boost patient satisfaction, and ultimately strengthen the health care system as a whole, leaders asserted.

“Given the significant distances rural health services must cover, simple interventions—both medical and non-medical, potentially guided by technology—can offer a win-win-win solution for payers, patients, and providers committed to delivering quality care,” Agarwala said. 

Overcoming Technological Challenges: A CEO’s Imperative

But executives must overcome some technological challenges to effectively integrate and deploy telehealth in rural areas, leaders said. While telemedicine holds great promise, broadband accessibility remains a significant issue. As Schneider pointed out, “20% of counties do not have broadband connectivity.” This digital divide is a substantial obstacle to implementing telemedicine solutions in many rural areas.

Bridging this digital divide is essential. Leaders have the power to invest in technology infrastructure and foster partnerships that address broadband challenges in underserved regions. By leading efforts to expand broadband access, organizations can unlock the full potential of telemedicine and other innovative technological solutions in rural communities.

“I believe in the valuable role of automation and AI,” said Ibrahim. “I think rural health, in particular, is prime to begin testing and piloting those kinds of solutions. However, challenges, including cultural barriers and a need for IT expertise, exist. Moving the needle in this space will require considerable time and effort,” he added.

The Workforce Challenge: An Opportunity for CEO Leadership

Leaders noted that new technologies also could help to alleviate rural workforce shortages. For example, Schneider said executives should implement tools that make workflows more efficient and ensure clinical staff can work at the top of their licenses.

“For those of us who are trained as physicians, the amount of paperwork we do is mind boggling in a world where there’s advanced technology. There’s a lot of investment that you can do to strip that out,” Schneider said. She continued, “To me, the most exciting part of AI advancement is its potential to mitigate inefficiencies and therefore allow us to expand the scope of practice for people, such as community health workers, medical assistants, pharmacists, and other trusted caregivers in the ecosystem.”

Ibrahim agreed, but he also highlighted the multifaceted nature of rural health care’s workforce challenges. “I think, fundamentally, rural health care is challenging because there’s so many different facets of it that make it difficult to transition. There are significant infrastructural issues and challenges with family resources and educational systems that, for younger emerging physicians or leaders, make rural areas less attractive places to move to.”

Leadership is crucial in addressing the rural workforce challenge, the discussion leaders said. By implementing tools and initiatives that make rural health care more attractive to health care professionals, organizations can combat the shortage. For example, leaders emphasized the importance of collaborating with medical schools and educational institutions to create pathways for emerging physicians to practice in rural areas.

Regulatory Reform: Clearing the Path for Change 

Leaders also underscored the need for regulatory reform to support these innovative solutions. They noted that regulatory barriers and outdated payment models are major roadblocks to progress.

For example, participants in the conversation said health care executives should lead the charge in advocating for telemedicine reforms, including support for increasing rural broadband access and the removal of regulatory and payment barriers for telehealth services.

In addition, leaders highlighted the urgency for regulatory reforms that would expand care teams and better leverage pharmacists in a patient’s care journey, which could help to increase rural patients’ access to care.

Leaders said health care executives should collaborate with industry stakeholders, government bodies, and other health care organizations to advocate for policy changes that foster innovative care models and eliminate outdated regulations that make it more difficult to expand and ensure care access in rural areas. 

Collaboration and Action: Your Leadership Role 

While rural health care presents intricate challenges, leaders underscored the significance of collaboration among health care executives, regulatory bodies, and technology innovators to revolutionize health care delivery in these areas. By taking the lead in advocating for regulatory reform, embracing telemedicine, addressing workforce challenges, and overcoming technological barriers, executives can play a vital role in ensuring rural communities’ access to high-quality health care.

Ashley Antonelli

Senior Manager, Executive Communications

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