Beyond telehealth: How personalized care can improve outcomes for vulnerable populations - MedCity News

In recent years, telehealth has emerged globally as an indispensable resource at a time when in-person visits were not an option. Telehealth undoubtedly provides many benefits for both patients and providersinclusive increased access to services, greater convenience, reduced clinical overhead and deeper insight into patients’ lives. But telehealth does not provide comprehensive care for a growing group of patients—those with significant and multiple chronic conditions.

Before we can consider telehealth as part of ongoing, long-term health care, there are major issues that need to be addressed, including integration with traditional health services and disparities between patient subgroups that stem from economic, infrastructural, and technological barriers.

We also need to integrate additional capabilities, such as remote patient monitoring, to obtain more comprehensive patient data and drive specific interventions.

Technology and healthcare as we know it today

Telehealth is part of the rapidly growing field of digital health. Telehealth refers to the ability for patients to interact virtually with doctors and therapists and also includes a range of remote monitoring capabilities, including pulse oximeters and blood glucose meters to treat conditions such as high blood pressure and diabetes respectively.

Historically, telehealth was primarily used to serve patients in rural areas who did not have easy access to healthcare facilities. Recently, however, telehealth has quickly become the fastest-growing way to deliver healthcare, revolutionizing the way doctors and patients interact.

Before the start of the pandemic, the national volume of telehealth services was projected to reach 3.6 million visits. But the use of telehealth has grown during the pandemic as patients look for safe ways to access treatment and actual volumes exceeded 120 million visits at the height of the pandemic and throughout the rest of 2020..

Disadvantages of telehealth for vulnerable populations

The widespread adoption of telehealth shows that this technology may actually exacerbate access disparities, especially when it comes to vulnerable US populations, including racial and ethnic minorities, non-English speakers, low-income people, and the elderly.

Take the elderly population for example. Over time, seniors who rely heavily on telehealth may find themselves with less social interaction and less likely to leave their homes after major life events, such as bereavement or retirement. Primary care, delivered primarily through telehealth services, also limits the provider’s ability to perform physical examinations and does not introduce older adults to interactive settings that can help combat the effects of social determinants of health, such as loneliness and isolation.

To provide more comprehensive care that holistically improves health outcomes for vulnerable patient populations, care teams must integrate digital enhancements—remote monitoring devices, virtual visits, mobile health apps—with long-term care plans, peer support, and programs , targeting social determinants of health.

The future of the care team and the tools they will use

As technology advances, we can continue to develop innovative care models that use telehealth services to improve patient care. The provider concept must go beyond the physician to include the use of digital tools as well as a multidisciplinary care team, family, caregivers, and peer support. Telehealth, which augments rather than replaces, promises more efficient, equitable, and accessible patient care for even the most vulnerable populations.

The combination of digital technology with more traditional healthcare allows care teams to unobtrusively track health conditions and outcomes in a way that technology or physical hospitals alone cannot.

Take, for example, someone with congestive heart failure who has gained weight. With a digital scale and a wearable device that measures vital signs, a care provider can monitor fluctuations in oxygen and heart rate to know if a patient is at risk of worsening congestive heart failure, allowing for early intervention.

Furthermore, by integrating peer support into comprehensive treatment plans, we can help close the growing communication gap between patients with chronic conditions and the physicians who support their care. While peer support is rarely integrated into traditional treatment plans, studies have shown that improves clinical outcomes for a wide range of chronic mental and physical health conditions from promoting recovery and promoting empowerment.

Peer support efforts that are designed to meet the unique psychosocial and health needs of people with chronic illnesses can actually have a positive impact on them and, in some cases, can reduce hospitalization rates.

The more we look at health care holistically, as an ecosystem that includes patients, doctors, caregivers, and technology, the better we will be able to improve patient health outcomes and overall quality of life.

Photo: elenabs, Getty Images

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