Digital Health Equity

Virtual care is the path to creating digital health equity and expanding access to care for rural and disparate populations. However, expanding access to healthcare within these groups requires modalities that work within their limitations. The conversation has shifted from urban versus rural access and utilization to acknowledging all underserved populations as a whole, regardless of their geographic limitations.  

Today, there are populations in both rural and urban areas that don’t have sufficient access to healthcare because they lack the tools needed to engage in virtual care.  

Expand Access to Healthcare & Digital Health Equity —
Part of our Asynchronous Care Guide

When we built this guide, we set out to create a single comprehensive resource for everything healthcare professionals will ever need to know about asynchronous telemedicine. It’s 29 pages of pure data, research, and the largest case study ever conducted on async. On this page, you’ll learn how asynchronous telemedicine expands access to healthcare and improves digital health equity.

Looking for information on a specific topic? Use the buttons below to navigate to different sections of the guide.

The Internet Divide Limits Access to Care

Even within virtual care, there are different levels of accessibility. For example, we know that rural populations often struggle with access in terms of physical distance from care facilities as well as limited bandwidth and cell signal. Rural and low-income populations may have metered internet speeds or limited access to broadband. Asynchronous telemedicine excels in these circumstances because it requires lower bandwidth and can help address patient concerns efficiently before connecting them with a provider via another modality. This allows patients to avoid an unnecessarily expensive and time-consuming drive to a clinic or a data-consuming video visit.

INTERNET SPEED COMPARISON

Video visits require a stable connection that can support speeds of 1.5 mbps/1,500 kbps for the entirety of a visit. An average 15-minute visit will consume 1,350 megabits or 162.5 megabytes. If your metered internet plan is limited to a gigabyte, that visit consumed 16% of a patient’s monthly capacity. 

Intelligent adaptive interviews excel even when internet is unstable, requiring 1.2 mbps to load the initial page in one second or 0.4 mbps/400 kbps for a three-second load time. Using a modern single page application architecture, each additional page requires 10 kbps to load in one second. The entire asynchronous telehealth visit likely consumes less than 1 megabyte of a data plan.

asynchronous virtual care access
access to care

Fun Fact:  Remember dial up modems? They topped out at speeds of 56 kbps, but Zipnosis async adaptive interviews would still be able to run on decades-old technology. It would take 20 seconds for the initial app to load and then less than a second on the screens that follow.

access to care

Fun Fact:  Remember dial up modems? They topped out at speeds of 56 kbps, but Zipnosis async adaptive interviews would still be able to run on decades-old technology. It would take 20 seconds for the initial app to load and then less than a second on the screens that follow.

Rural Reach & Access to Healthcare

When evaluating health equity in rural markets, it is valuable to reflect on the triple-aim of telemedicine:
patient experience with asynchronous telemedicine
Improving the individual experience of care
access and population health with async virtual care
Improving access and the health of populations
reducing cost asynchronous telemedicine
Reducing the per capita cost of care
urgent care
Improving the individual experience of care
primary care
Improving access and the health of populations
primary care
Reducing the per capita cost of care

The goals of improving individual experience and access to care for rural populations have some of the highest barriers to success:
     Traveling distance
     Lack of specialists
     Lack of broadband to support video
     Closure of rural hospitals

These factors directly impact the ability to decrease the cost of care. Within healthcare leadership, we often consider internal efficiency as the key to drive down cost; however, we have to consider the cost incurred by the patient. If bandwidth is a limiting factor and providers are an hour away, the following exponentially drive up direct and indirect costs for patients:
     Long trips to the clinic result in missed work and lost wages, plus the cost of gas

     Lack of broadband means video visits aren’t an option
    
Limited access to primary care, urgent care, hospitals, and specialists

All of the above are key drivers of delayed and avoided care — which ultimately leads to more complex cases and higher healthcare costs.

Often health organizations focus on driving adoption of patient portals and embedded synchronous care applications. However, it is impossible to drive down the per capita cost of care if you only focus on your known populations and existing strategies. An advanced virtual care strategy should factor in a Digital Front Door® solution that accounts for those who do not have an established relationship with the organization.   

A successful Digital Front Door® strategy has proven to expand a health system’s geographic reach, outside their immediate communities and into rural populations. For example, in studying virtual visits completed during flu season, one health system found that their Zipnosis-powered virtual care platform hosted visits from patients in more than 40 counties across Alabama. From these visits, the asynchronous protocols identify higher acuity patients — triaging and routing them to a more appropriate point of care. The combination of a Digital Front Door® with async broke down barriers and helped address the issues of delayed and avoided care. With a strong Digital Front Door® strategy, health systems can better reach patients across a broader service area while also improving access to care.

rural access to healthcare solution

The goals of improving individual experience and access to care for rural populations have some of the highest barriers to success:
     Traveling distance
     Lack of specialists
     Lack of broadband to support video
     Closure of rural hospitals

These factors directly impact the ability to decrease the cost of care. Within healthcare leadership, we often consider internal efficiency as the key to drive down cost; however, we have to consider the cost incurred by the patient. If bandwidth is a limiting factor and providers are an hour away, the following exponentially drive up direct and indirect costs for patients:
     Long trips to the clinic result in missed work and lost wages, plus the cost of gas

     Lack of broadband means video visits aren’t an option
    
Limited access to primary care, urgent care, hospitals, and specialists

All of the above are key drivers of delayed and avoided care — which ultimately leads to more complex cases and higher healthcare costs.

Often health organizations focus on driving adoption of patient portals and embedded synchronous care applications. However, it is impossible to drive down the per capita cost of care if you only focus on your known populations and existing strategies. An advanced virtual care strategy should factor in a Digital Front Door® solution that accounts for those who do not have an established relationship with the organization.   

A successful Digital Front Door® strategy has proven to expand a health system’s geographic reach, outside their immediate communities and into rural populations. For example, in studying virtual visits completed during flu season, one health system found that their Zipnosis-powered virtual care platform hosted visits from patients in more than 40 counties across Alabama. From these visits, the asynchronous protocols identify higher acuity patients — triaging and routing them to a more appropriate point of care. The combination of a Digital Front Door® with async broke down barriers and helped address the issues of delayed and avoided care. With a strong Digital Front Door® strategy, health systems can better reach patients across a broader service area while also improving access to care.

rural access to healthcare solution

Creating Digital Health Equity for Non-English-Speaking Populations

Non-English-speaking populations are often a large segment of rural markets; however, the language barrier can create similar challenges in urban markets. Some common barriers include:
     Lack of fluent administrative staff
     Even fewer fluent clinical staff
     Longer wait times due to the above or a need to wait on translation services
     Video visits run longer due to waiting on a translator, which drives up data consumption and results in indirect cost increases for patients
     The hassle compounds the risks of delayed and avoided care

Telehealth programs and Digital Front Door® strategies need to account for these issues by starting with the largest segment, Hispanics. According to the U.S. Census Bureau, they represent 18.7% of the US population, and Spanish is the dominant language for 13% of the United States. Asynchronous telemedicine is uniquely suited to serve these populations. The Zipnosis platform and associated protocols leverage a dynamic content management system that:

     Translates all patient-facing text into Spanish
     Translates patient inputs back into English for providers
     Presents care plans and educational materials to the patient in Spanish

Providing built in translation technology provides relief for clinical and administrative staff. It also creates an exceptional patient experience for Spanish-speaking populations. This is especially true for low acuity cases. However, the improved experience and accessibility also result in identifying, triaging, and routing higher acuity cases to the appropriate point of care.

 

Creating Digital Health Equity for Non-English-Speaking Populations

Non-English-speaking populations are often a large segment of rural markets; however, the language barrier can create similar challenges in urban markets. Some common barriers include:
     Lack of fluent administrative staff
     Even fewer fluent clinical staff
     Longer wait times due to the above or a need to wait on translation services
     Video visits run longer due to waiting on a translator, which drives up data consumption and results in indirect cost increases for patients
     The hassle compounds the risks of delayed and avoided care

 

telemedicine access nationwide

Telehealth programs and Digital Front Door® strategies need to account for these issues by starting with the largest segment, Hispanics. According to the U.S. Census Bureau, they represent 18.7% of the US population, and Spanish is the dominant language for 13% of the United States. Asynchronous telemedicine is uniquely suited to serve these populations. The Zipnosis platform and associated protocols leverage a dynamic content management system that:

     Translates all patient-facing text into Spanish
     Translates patient inputs back into English for providers
     Presents care plans and educational materials to the patient in Spanish

Providing built in translation technology provides relief for clinical and administrative staff. It also creates an exceptional patient experience for Spanish-speaking populations. This is especially true for low acuity cases. However, the improved experience and accessibility also result in identifying, triaging, and routing higher acuity cases to the appropriate point of care.

 

telemedicine for spanish speakers

Ready to dive deeper into asynchronous telemedicine?

When we built this guide, we set out to create a single comprehensive resource for everything healthcare professionals will ever need to know about asynchronous telemedicine. It’s 29 pages of pure data, research, and the largest case study ever conducted on asynchronous telemedicine.

Continue to another section, or download the full guide today.

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