Spurred by the pandemic, the movement to decentralize healthcare has taken off in the past few years. Patients now have an array of digital tools to help them manage their chronic conditions at home, such as remote monitoring devices, telehealth hubs and smart scales.
These home health solutions are valuable tools that have proven to do a good job of improving patient outcomes — but only for certain groups. That’s according to Larry Cohen, CEO of Health2047, the American Medical Association’s venture studio.
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In an interview last week, Cohen pointed out that many Americans lack the resources or know-how needed to benefit from digital tools for chronic conditions management. He also highlighted community engagement as an highly effective tool that many healthcare organizations are overlooking in their quest to close health equity gaps and improve patient outcomes.
Most digital tools for managing chronic conditions require a stable Internet connection, which not all Americans have access to, Cohen pointed out. Many of them also require that the patient own a device like a tablet or smartphone — other things providers shouldn’t just assume patients have access to, he added.
“They might need computers, telephones or a variety of technological advances in order to stay in touch. Not everybody has that. Some of the people most in need of these programs are the people that don’t have access to the technology that allows them to participate,” Cohen declared.
It’s also important to mention that nearly 95% of U.S. adults ages 60 and older have at least one chronic condition. However, many older Americans did not grow up around technology and still do not use digital tools very much in their daily lives, so it’s not easy for them to set up devices at home or create new accounts on their own, Cohen noted. While some older patients may have family members to come over and walk them through these processes, providers shouldn’t assume that that is the case for everyone, he said.
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There is hope, though. The healthcare world is finally beginning to acknowledge the huge disparities that exist within it, especially in terms of access and outcomes. Now that the industry is recognizing these inequities, Cohen hopes that stakeholders will come together to pilot innovative approaches that can help all patients better manage their conditions, regardless of their situation.
Technology innovation is great, but healthcare leaders shouldn’t underestimate the power of having boots on the ground. Cohen emphasized the importance of deploying community healthcare workers who are focused on face-to-face engagement with members and patients.
Zing Health, a startup that Health2047 spun out in 2019, is an example of a company that has experimented with different approaches to getting patients engaged in their health, he noted. The Chicago-based Medicare Advantage plan, founded by two Black physicians, is designed for those traditionally underserved by existing health plans. Zing reaches its members through community-based teams who can understand and overcome social barriers to care.
“The amount of time it takes them to reach the members that they have enrolled in their program is really quite significant. They are constantly examining how to contact these people, whether it’s snail mail, telephone, text, etc. They are trying to get real-time, consistent information from these individuals, so they just need to have people in the community — people who are who are actually knocking on doors,” Cohen explained.
There are millions of Americans, especially among groups who have been historically discriminated against or underserved by the U.S. healthcare system, who have a low degree of trust in traditional healthcare facilities. That is why it’s so critical for healthcare organizations to have a presence in the community, Cohen pointed out. Hospitals and clinics are places often regarded as intimidating, stressful, sterile and impersonal — but laundromats, grocery stores and churches aren’t.
Zing Founder Eric Whitaker “was one of the first people in Chicago” to go to barber shops and talk to Black men about hypertension and what they can do to prevent or manage the condition, Cohen noted.
“In a barber shop, where you’re surrounded by people just like yourself and everybody is fairly relaxed, [Whitaker] found that he could talk about hypertension. In those settings, you can actually get people to do things. It is absolutely necessary to do that rather than have people flock to hospital settings. We need to meet people on their own ground as much as possible,” he said.
SiteBridge Research, which Health2047 spun out in 2021, operates outside traditional healthcare settings as well, Cohen highlighted. This startup is not focused on chronic conditions management, but rather clinical research. Typically, individuals need to make regular visits to a large academic medical center in order to participate in a clinical trial. This means that rural patients or those without reliable transportation aren’t adequately represented in clinical research.
The pharmaceutical industry has recognized that the lack of diversity in trial participants is a serious issue, but there is still a lot of work to do to solve this problem, Cohen remarked. SiteBridge seeks to address the issue through its platform, which allows small practice physicians in rural areas to conduct clinical trials in their communities. The platform is two-sided, meaning that it matches pharmaceutical companies to physicians looking to involve their patients in research.
As technology continues to advance, startups can’t forget how effective community engagement can be, Cohen declared.
Photo: gmast3r, Getty Images
