AcuteCare Telemedicine Blog


Will Mobile Technology Help Close The Digital Divide?

A recent study is revealing that patients using telemedicine are more likely to be urban and well educated. Based on data from 53,000 households collected by the Census Bureau in July 2011, the report found 8 percent of urban Internet users took part in telemedicine initiatives, compared with 4 percent in rural areas. That stands in contrast to telemedicine’s common selling point that it can more effectively and conveniently provide services to people in remote locations.

Participants were also found to be wealthier.  At income levels of $100,000 or more, 11 percent of Internet users took part in remote care, compared 4 percent from households in the under $25,000 bracket.  The 25-44 age group was found to be the most likely segment using online services for medical care and information.

As access to telemedicine opportunities continue to grow it is expected that the demographics will likely shift to include lower-income and less-educated patients.  One technology that may improve access to telehealth services is the mobile or smart phone devices which appear to be closing the digital divide among various demographic segments of the population. Mobile technology has become especially critical for low-income minorities who have no other technological means of connecting to the internet.

Survey results released in September by the Pew Research Center’s Internet & American Life Project indicate that African Americans and Hispanics are more likely than whites to own a smartphone, with 49 percent of Hispanics, 47 percent of African Americans, and 42 percent of whites owning these mobile devices.  For these groups, mHealth has the potential to be a powerful tool in promoting healthy living and preventive medicine, particularly in combating the high rates of diabetes in these populations.

Development of new and innovative health related mobile applications and growing the number of smart phones in the hands of the more economically challenged population promises to be an effective means to bridging the healthcare gap in America. Health and Human Services (HHS) has called on developers to create a mobile application to help educate minorities and women about cancer screenings and allow secure access to medical records.

Only time will reveal whether telemedicine’s promising benefits of increased access and lower cost of quality medical care will better attract and reach those who are most in need.



Medicare Recipients to Lose Telemedicine Services Benefits

Even though the availability of telemedicine has proven its value by lowering costs, increasing access and improving treatment and remote monitoring for chronic diseases, thousands of Medicare beneficiaries will soon lose access to telemedical services simply because of where they live, or more accurately stated, how government statistics identify where a patient lives.

Medicare patients from Hawaii to Puerto Rico to Minnesota will be redefined as living in “metropolitan” areas, precluding them from receiving Medicare coverage for video conferencing and other telehealth activities, even though 80% of beneficiaries live in urban counties such as those cut from the list.

“Congress has long overlooked the need for telemedicine services for residents of urban counties, despite the fact that they often suffer similar problems accessing healthcare.  Now, because of a statistical quirk, even more people will lose coverage of these services, reducing access and care,” said Jonathan Linkous, CEO of the American Telemedicine Association.

Originally, telemedicine technology demonstrated its most obvious benefits to rural communities, where specialized and chronic medical services and treatments were often not readily available without significant cost and inconvenience to patients.  However, the same cost/availability benefits have proven to be just as effective in urban areas and when chronic illness and extended, after hospital, care is encountered.

A study provided by the Commonwealth Fund shows that telehealth consultations are effective in reducing the amount of time patients spend in the hospital for care of chronic illnesses.  By examining data from large telehealth programs run by the Department of Veterans Affairs (VA), Partners HealthCare in Boston, and Centura Health, based in Colorado, researchers found that home monitoring programs can cut costs and raise patient satisfaction up to 85%.  Under the new guidelines, Medicare coverage will not be available for telemedicine visits to beneficiaries living in metropolitan areas–where over 80% of recipients live, resulting in cost reductions for the Medicare program.  Correcting this oversight will require an act of Congress, another incident of bureaucratic, regulatory interference with beneficial advancements in the delivery of healthcare to patients all around the country.

Given the increased involvement of government in the total delivery of health care in the coming years, this lack of insight does not bode well for reducing costs and improving availability to those who are most in need of the best in healthcare services.