In this article, we will discuss the health inequalities and the role of Telehealth to improve on those equities that are extremely necessary.
Health is a human right. And first and foremost, we have to understand what health really is. It’s a multi-dimensional concept that goes beyond the mere absence of illness. So health is more than just not being sick and it has a multidimensional effect. So, the way we determine health is actually a construct that different people use in different ways. This is one of the best ways that has been done.
The way they define determinants of health is by defining what holistic health vs just medical care really are and how we’re going to deliver that. But more importantly, we need to understand what a good health outcome is. It depends on two different things (1). One is the length of life and then the other one is the quality of life and both are about 50 percent each. So health outcome is more than just access to care. As a matter of fact, only 20% of it is about health care and access to care. 30% is health behaviors, 10% is physical environments and then socioeconomic factors play a significant role in health inequalities in general.
As a matter of fact, our ZIP code matters more than our genetic code. Our work status, education, family, income, community, and all the physical essences have a greater impact on our health because in a lower zip code inner-city, the air and water quality could be bad. There could be more lead paint because of the older buildings. So, clearly, the ZIP code is sometimes more important for our overall health than our access to healthcare.
Unfortunately, we often victim shame people for their bad behaviors like tobacco, diet, alcohol, etc., But believe it or not, it’s only 30% that it accounts for because as we already discussed, health is made up of multiple different factors and these social determinants are interconnected.
So where does telehealth comes in? Telehealth is clearly an important point to give access to. Even though clinical care is important, one of the main issues it has is that when we have lower social determinants of health, then access to care becomes very low. It will have a great impact on how we can access care. And that’s where, in the age of telehealth, broadband access becomes such a key thing (2). It is now as important as a public utility like electricity and heat. It is now a public health issue. So anyone and everyone should have access to broadband, and this should be a national priority.
And that’s one way we come to this point that telehealth is not just medical care. Through telehealth, we can identify more things than usual clinical care because if the patient is at home, we can look at the surroundings and safety in their house. We can also see, if the patient has adequate space, water, air, etc., So, through telehealth, we can actually be in their house without even visiting it which is truly amazing! We can actually take care of these patients on a whole complete basis and provide them with appropriate care. Not just medical-wise but also non-medical, social, nutrition, child support, whatever it may be and we can have a flow-through of the system that can help these patients as human beings in general as well.
The following are the key promises of Telehealth.
The first and foremost is access which includes both timely care as well as value care. Due to Telehealth, we can provide value within their own houses. They don’t have to drive or take the bus, they know how to take the time off which saves them a lot of money and the patient is self and we are getting in their room. So, with the time spent, we get a lot more out of it. Therefore, just by the definition of the visit itself, it creates a lot of value and of course, the downstream revenue benefits are extremely well because we can give access timely and if the issue is solved with a small dose of antibiotics or asthma met inhaler or anything as compared to the patient getting too sick, coming into the hospital in an ER and going to the ICU. So there’s a tremendous amount of value with Telehealth.
The second key promise is that we can also access allied care. We can have specialty care with the help of a wound nurse going to their house. But we do that already right? The patient goes to the hospital, then ER, then ICU, and then the wound nurse goes to their home. Why not decrease the inpatient side of things by providing care to the patient where it’s needed directly? Similarly, specialists like lactation consultation, social workers, therapists like speech therapy, physical therapy, occupational therapy, nutritionist, etc., can provide their care via telehealth and this can significantly change the way the patient has their health outcomes. This will be a significant improvement, not just providing medical care, but holistic care in general.
The third promise of telehealth is analytics. As we know, all these data of patients can be analyzed and pumped into a population database. Like, for example, if people living in a neighborhood have multiple asthma attacks, then the air quality of their whole neighborhood needs to be investigated. So these analytics can show up as an early warning sign, and this is where artificial intelligence and Telehealth become extremely important as all this data needs to be turned into knowledge. And then once that knowledge is there, the wisdom for the policymakers can be there.
“If you save a life, it is as if you saved the life of all mankind.”