- Using innovative HIT infrastructure tools to give patients better access to care options, including broadband improvements for telehealth, can help improve the quality of care for cancer patients in rural areas, according to a National Institutes of Health (NIH) Funding Opportunity Announcement (FOA).
The population of rural counties in the United States is estimated to be between 46.2 million to 59 million people compared to the 250 million people living in urban areas.
People in rural communities face more obstacles when seeking healthcare than urban patients. Rural communities face higher poverty rates, lower education levels, higher elderly population, lack of accessible health services, and limited resources to support public health infrastructure.
As a result, rural communities face higher rates of mortality and “greater percentages of potentially excess deaths,” and face transportation issues and medical mistrust, according to NIH.
Rural communities rely heavily on their network connections to gain access to telehealth programs. Many rural patients, especially those who are terminally or chronically ill, depend on telehealth to improve their quality of life without needing to take long and taxing trips to their provider.
“Although most research does not indicate that residing in a rural area is independently associated with substantially worse survival, there is evidence suggesting that individuals treated at lower-volume hospitals experience worse survival than those treated in higher volume facilities, and that rural cancer patients are more likely to receive treatment in lower-volume hospitals,” said NIH.
“There is also evidence to suggest that rural cancer survivors experience worse quality of life and mental health outcomes than survivors from urban areas, and they may be less likely to use hospice care at the end of life.”
The FOA suggests that:
- Limitations in information technology may limit access to patient portals, telehealth, or other proposed strategies to improve patient-provider communication and care in rural communities
- IT-enabled, team-based care delivery models could improve the delivery of guideline-concordant, high-quality cancer care among rural populations (e.g., studies of innovative care delivery interventions using telemedicine and other technologies or novel strategies designed to deliver comprehensive, coordinated, high-quality cancer-related care to rural low-income and/or underserved populations)
Taking advantage of infrastructure technology can potentially improve patient access to care as well as improve the quality of care they are receiving.
Last spring, AMIA stressed the importance of broadband for rural medicine, declaring in a letter to the FCC that broadband needs to be categorized as a social determinant of health.
“FCC has a critical role in ensuring that Americans benefit from the electronic health infrastructure that was initiated with the passage of the Health Information Technology for Economic and Clinical Health (HITECH) Act, and supported by the 21st Century Cures Act,” AMIA wrote.
AMIA believes that social determinants include access to health information and care via broadband-enabled technologies.
AMIA informatic professionals outlined several recommendations and observations FCC can follow to ensure the improvement and accessibility of broadband-enabled healthcare solutions for patient care.
In the fall of last year, the FCC Connect2Health Task Force announced its collaboration with the National Cancer Institute (NCI) on how to increase broadband access and adoption in rural areas.
Project L.A.U.N.C.H. (Linking and Amplifying User-Centered Networks through Connected Health): A Demonstration of Broadband-Enabled Health for Rural Populations in Appalachia, focuses on areas that have high cancer mortality rates and little access to broadband.
Broadband connectivity in rural areas has been a challenge for healthcare organizations over the years. Rural patients benefit from telemedicine programs but as providers continue to digitally transform their health IT infrastructure, caregivers depend more on digital tools that require network connectivity.
As organizations continue to realize the importance of broadband connections for rural communities to increase care quality, more action is being taken to bring this technology to more rural communities.
NIH advised that there should be greater collaboration among research communities that traditionally have not played a part in rural healthcare infrastructure including demographers, geographers, transportation researchers, economists, and sociologists.
Consultation for building a better rural healthcare network for improving cancer care should also not be limited to professionals who specialize in cancer care.
“Applicants are strongly encouraged to collaborate with organizations and programs with experience or infrastructure (e.g., telemedicine, social, clinical and behavioral health services) designed to address other health or social problems in rural populations that could afford substantial opportunities to improve cancer care quality, delivery and outcomes,” said NIH.
“For example, partnerships with community-affiliated clinics or hospitals, state or county offices of rural health, departments of health, education, or human services, or other community organizations, and engagement of community advisors are strongly encouraged.”
Organizations are learning to use advanced health IT to address issues that have plagued the healthcare industry for a long time. Rural patients have always had trouble getting specialized care and making the physical journey to their healthcare providers.
By taking advantage of broadband connectivity and telemedicine, rural patients have the opportunity to receive the same quality of care as their urban counterparts.