Digital Health: The Access Problem

Digital health has become a necessity in the wake of Covid-19. Though much progress has been made in implementing digital solutions quickly, much needs to be done to bridge the access gap, as many of the most needy patients are being left behind.

Smartphone Use

Many clinics and hospitals have adopted various platforms to offer virtual visits. These virtual visits are usually conducted on a tablet, smartphone or on a computer. Popular vendors are Doxy.me and Zoom. However, according to an article by the Pew Research Center, roughly 4 out of 10 people over the age of 65 do not own a smartphone. The patient population tends to be skewed toward older adults, meaning that a greater percentage of patients are being left out of the ability to participate in virtual visits. This technology gap has proven to be frustrating to patients, physicians and caregivers.

New technologies are emerging that are focused on ease of use and accessibility, such as Sirona.tv. Sirona.tv uses the patient's existing TV and a pre-configured set top box to connect to a HIPAA compliant FHIR based EMR. Virtual visits can be conducted using the patient's TV, which offers the patient a hands-free experience and the provider a wide view for a more thorough examination.

Lack of Internet Connectivity

In addition to the lack of technical ability, many patients lack an internet connection in their home. Without an internet connection, most telehealth has to be conducted by telephone, drastically reducing effectiveness. While some devices offer cellular data, most patients in this category do not own such devices.

The lack of internet connection is another access point in which Sirona.tv has focused. The company offers a model that uses cellular data at a slightly higher price, but still far less expensive than a tablet.

Remote Patient Monitoring

Remote patient monitoring faces the same technology barriers in terms of ability and connectivity as virtual visits do, but add to that RPM appears to be the least effective patient engagement initiative according to NEJM Catalyst Insights Council survey. The data collected by patients Popular fitness wearables tracking physical activity appeared to have large variations of accuracy with error margins up to 25 percent. In addition, it was shown that smartphone apps can have an even larger rate of a 30% failure rate. The lack of reliability is the most serious problem that needs to be fixed before devices and applications could be used by healthcare providers.

In addition, much of the data collected by remote patient monitoring has to then be integrated into the electronic medical record, which can be costly and inefficient. According to an article in Health IT Outcomes, "After the data have been collected, IT departments have to redirect it from RPM devices to electronic medical record systems (EMRs) by the means of multiple third-party applications."

In addressing the problem of accuracy in measurements, Sirona.tv has employed the use of Bluetooth enabled health trackers. These connect automatically with the system and are uploaded automatically to the EMR once a correct reading has been obtained. This seamless integration provides the accuracy needed and eliminates any data entry or redirection required by an IT department. Further, the system can be set with vitals thresholds, determined by the provider, to send alerts. These alerts can fall into different tiers of severity and can be directed to the physician's cell phone, if desired.

Many of the most venerable patients, and the ones who could benefit the most from digital healthcare are being left behind due to lack of technical ability and access to the internet. Fortunately, technological advances are helping to close that gap by providing an interface that does not require technical ability and internet connectivity.