Rural and urban areas don't face the same challenges when it comes to health. But information technologies, and especially mobile devices can improve health distribution in rural areas.
Mobile health is a hot trend. Many studies identify new usages and behaviors that emerge from those healthcare apps or services, but very few take a closer look at the differences between rural and urban areas, in terms of penetration of mobile health, but also of the impact those technologies can have on local populations. A working paper from the UnitedHealth* points out that “fifty million Americans live in rural areas” and as a matter of fact, rural populations face some unique challenges concerning health and healthcare.19.5 percent of Americans living in rural areas “report being on fair or poor health compared with 15.6 percent of urban residents.” There are half as many physicians per 100,000 population as in urban areas, and while there are clinics and hospitals, patients often have to travel about 60 miles for specialty care, and a third of the hospitalizations of rural patients happen in urban areas.
Mobile devices and telemedicine can improve health delivery in rural areas
In this context, can mobile health be a solution to improve rural patient’s access to health services? Mobile devices are already being used in rural areas, with different types of applications: the transmission of clinical data and images from the patient to a medical center, improving the communication between patients and remote health care professionals, telepharmacy – which makes it easier for rural patients to order medications. Of course, health devices connected to mobile phones can be useful for physicians to get a patient’s blood glucose levels and vitals for instance. Robots can also be used in remote surgery – although this is a fairly new field. While those technologies all improve the communication between patients and physicians or between rural physicians and remote experts, barriers to adoption remain.
Physicians see further adoption as a challenge
33% of rural physicians use digital imaging reads, 17% consult with specialists remotely, 9% consult online with patients. 56% do not use telemedicine. On the patients’ side, mobile health adoption is fairly low - essentially the same rates from urban to receive text updates on health (10 to 11 percent) or use health-related apps (11 to 12 percent). The main barriers to the adoption of telemedicine to improve care in rural areas are, according to primary care physicians: the cost of equipment, reimbursement, administrative hassle, and the need for training. On the consumers’ side, a lot of it has to do with IT infrastructure or with the penetration of smartphones. 74 percent of rural residents use Internet, 77 percent own a smartphone, and 38 percent own a smartphone.
*Modernizing Rural Health Care July 2011