Smart tech makes strides in closing rural health care gaps

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(NewsNation) — There are few hospitals for the 14,000 residents in Atoka County, Oklahoma. There are few primary care doctors to identify diseases early, pharmacies to manage chronic illness or trauma centers for emergencies. If you need to see a specialist, you may have to drive for hours.

Atoka County is one of thousands across the U.S. lacking adequate health infrastructure. More than 80% of counties in the U.S. — where a third of the population lives — are considered “health care deserts.” 

And living in one can be perilous.  

Residents in these counties are more likely to die of cancer, pregnancy complications, heart disease and numerous other ailments that rely on timely treatment. They are more likely to struggle to receive treatment for drug addiction or mental illness. And they are more likely to be poor, elderly and uninsured.

Yet these communities are also a source for some of the most creative solutions in health care today. 

A library for hotspots 

How it works: Oklahoma State University Extension partnered with 19 rural libraries to loan internet hotspot devices, including Atoka County. Participants check out devices for up to two weeks at a time, and can use the devices to access telehealth appointments. Others reported using the hot spots to find jobs, access education and connect with family and friends — all factors that contribute to mental health. 

What this solves: Lack of fast internet is a major barrier to participating in modern life, especially in rural areas where people may have to drive for hours to see a doctor in person. Only 70% of Oklahoma’s rural areas have broadband access, and there are at least 12 counties with less than 50% access.

Evidence of success: Over a three-year rollout, each library loaned about 150 devices annually, and patrons reported a 95% satisfaction rate with the program. In one town of just over 2,000 people, the library’s six hotspots were checked out more than 600 times. 

Limitations: There are still large swaths in the western part of the state without participating libraries. And, the two-week timeline might limit longer-term telehealth.

Digital stethoscopes for kids

How it works: In four telemedicine Children’s Mercy clinics in Kansas and Missouri, technology specialists can examine kids virtually, using technology to take their vitals, listen to breath sounds, examine eyes, nose or ears, and perform skin examinations under magnification. Trained nurses are in the room with patients who come in person to their local clinic. Some longer-term patients have been given devices so they can attend their appointments in their homes.

What this solves: Missouri has some of the highest-ranked children’s hospitals in the country, yet they’re located at the edges of the state, in the city centers of St. Louis and Kansas City.

“The high demand for pediatric specialty providers and the constraints many families face regarding transportation, time off from work and school, and finances, made it obvious that traditional models of outreach health care were not sustainable,” Morgan Waller, director of telemedicine business and operations at Children’s Mercy, told Health Care IT News.

Evidence of success: Children’s Mercy Kansas City converted 65% of appointments to telemedicine during the pandemic. The hospital also says the parents of their patients reported less financial strain since they didn’t need to travel long distances for care.

Limitations: Although this system can help increase the number of patients specialists see in a day, it still requires hiring specially trained nurses to oversee appointments on site. Hiring nurses in rural areas continues to be difficult.

Smart sonographers

How it works: Artificial intelligence systems currently being studied can identify breast cancer or benign cysts by combining the two common ways humans read mammograms: digital mammography imaging and 3D ultrasounds. Using an AI system that learns over time can reduce screening costs and help radiologists feel more confident in their readings.

What this solves: About one in 11 radiology positions remain unfilled in the U.S., with a much higher proportion in rural areas. The AI system has “great potential in rural areas, where radiologists are in extreme scarcity and there are needs to save human resources of medical centers,” said Lingyun Bao, one of the researchers studying AI and radiology.

Evidence of success: These AI programs show impressive accuracy, with a recent study showing a high percentage of true positives without increasing false negatives — on par with experienced radiologists in a recent study.

Limitations: Currently, these machines are designed to improve the accuracy of cancer detection in dense breasts, which are more difficult for radiologists to read. And bringing these machines to be used “solo” in rural hospitals would still require specialized training. 


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