6 Barriers to Healthcare Access and How Telehealth Can Help
Telehealth technology is helping provide better access to healthcare and easing the healthcare disparity gap among core American populations from seniors to rural residents. Find out how telehealth is showing promise for some of the biggest challenges to equitable healthcare access.
While being one of the most technologically advanced and wealthy countries in the world, access to healthcare in the United States falls disappointingly short. And it’s not only the poor or disadvantaged who struggle with getting timely and appropriate access to healthcare services. Middle- and even upper-income Americans who live in rural communities or face mobility challenges are also at risk of not receiving or seeking out proper care.
While telemedicine cannot solve the greater issues of healthcare delivery in this country, telehealth is proving to be one method of equalizing the disparities in access to care among underserved or vulnerable populations. Here we explore some of the key barriers to healthcare access in the US and how telemedicine can help.
1. Transportation Barriers to Healthcare Access
Each year, 3.6 million Americans do not receive medical care due to transportation issues and 4 percent of American children miss a medical appointment for the same reason. And transportation is cited as the third most common barrier to healthcare access. Common transportation-related obstacles include long-distance travel, lack of a vehicle, costs, and inadequate infrastructure. While public transportation improvements like ridesharing, improved bus access, and bike lanes can moderately help in urban or suburban communities, these may not be possible or available in many rural communities.
How telehealth can help
Telehealth comes to you. Telehealth can close the transportation disparity gap by delivering virtual healthcare services directly to the patient, at home, school, or work. Telemedicine kiosks, just starting to roll out, could also provide more convenient accessible care in places like local pharmacies, airports, and universities, potentially easing the transportation burden for patients to and from the clinic.
2. Geographic Barriers to Healthcare Access
According to the US Census Bureau, approximately one in five Americans or 60 million people live in rural communities. And rural residents receive lower-quality healthcare and have worse outcomes on several scores compared to urban and suburban dwellers. Physician shortages, poverty, a greater number of uninsured, and long travel distances add up to major discrepancies in healthcare equality between urban and rural America and pose a challenge to the national healthcare system that must be addressed.
How telehealth can help
Telehealth is not location dependent. Available in urban and rural communities alike, telemedicine can alleviate some of the burdens in finding appropriate care within a reasonable distance from home or work. Beyond in-home video or phone consultations, telehealth services support rural health systems by providing remote access to specialists using broadband networks, high-resolution imaging, and mobile devices.
Telemedicine services available to rural communities include chronic care management, emergency care, home monitoring, ICUs, long-term care, online therapy and counseling, telepharmacy services, interpreter services, and patient-provider communication facilitation.
3. Access to Healthcare for the Elderly and Mobility-Impaired
Currently, 15% of the American population is considered senior, and nearly 40% have at least one disability, mainly an issue with mobility. In addition, the CDC reports that one in four US adults is living with a disability, and mobility issues are the most common. For the elderly or those with mobility challenges, getting to and from doctor appointments can be stressful, time-consuming, and ultimately so laborious that patients neglect to make or keep necessary appointments.
How telehealth can help
Telehealth makes health easy to track. In addition to in-home telemedicine consults, remote patient monitoring tools provide elderly and mobility-impaired patients with access to preventive or chronic disease management care without the need for continual in-person appointments. From collecting blood sugar to monitoring weight, heart rate, or blood pressure, remote patient monitoring devices can track essential health markers in real-time and alert care teams of anomalies. This technology fosters independent living in a non-invasive way and eases the transportation burden for routine check-up appointments.
4. Low Income and Access to Affordable Healthcare
According to the CDC, 4.5% of Americans failed to obtain needed medical care due to cost in 2017. While this figure may not sound striking, that translates to more than 13 million patients who went without care in just one year. But why are so many Americans going without care when federal assistance programs exist? For one, many poor American adults live in states that did not expand Medicaid benefits under the ACA and remain ineligible for financial assistance. Simultaneously, many eligible people may not realize they can get help.
How telehealth can help
Telehealth is cost-effective. In some cases, telemedicine may be a more cost-effective manner of treatment compared to more traditional healthcare delivery channels - especially if transportation or mobility issues are also at play. The key is to increase awareness of telehealth as a viable, convenient, and more affordable method of treatment for common ailments among low income populations, the uninsured, the elderly, and those in rural areas. Even if families may not have a home computer, someone in the family probably has a smartphone. And free internet for connecting to appointments is available at local libraries or other community wifi hotspots if home internet is not available. Some telehealth providers also offer services on a sliding scale.
5. The Uninsured and Access to Healthcare
As of 2017, more than 27 million non-elderly were uninsured in America. Even under the Affordable Care Act, people cite the high cost of insurance as the biggest barrier to gaining coverage. And one in five uninsured adults went without needed medical care due to cost in 2017 - including preventive care for chronic diseases and major health conditions.
How telehealth can help
Telemedicine services don’t require insurance. Many of the largest direct-to-consumer telehealth platforms offer telemedicine visits at no additional cost to the uninsured. Flat rate visits average $40-$70 for primary/urgent care needs, $60 and up for dermatology, and $100 and up for mental health care. While still steep for those trying to make ends meet, when faced with an urgent medical need, telemedicine care can be cheaper than postponing treatment or heading to the ER.
6. Long Waits and Access to Healthcare
A recent study showed 24 days was the average wait time to schedule a physician appointment in 15 of the largest cities. Look at rural data and wait times can be even greater. Physician shortages and aging boomers are largely to blame for the lengthy waits. But putting off medical care can be devastating to patient health and ultimately lead to higher costs down the line, so finding ways to access affordable care in a timely fashion is critical.
How telehealth can help
Telehealth is timely. Telemedicine care can be provided on-demand in relatively real-time so patients don’t have to wait as long for needed care. The delay in receiving necessary treatment can negatively impact health through complications, emotional distress, and increased need for hospitalizations while increasing the cost of care. Providing immediate access to a physician or nurse practitioner consult can mean the difference between a $40 telemedicine bill and hundreds of dollars spent in the ER.