Addressing barriers to technology, telehealth care in underserved populations urgent
Key takeaways:
- Rural regions such as Appalachia have lower health care access than urban areas.
- Black and Hispanic patients are 30% and 40% less likely to see outpatient neurologists.
WEST PALM BEACH, Fla. — For patients with multiple sclerosis living in underserved areas, increasing access to health care professionals and removing barriers of access to technology are urgent needs, according to a speaker at ACTRIMS 2024.
“When you survey neurology residents, 90% of them plan to pursue a fellowship and many neurologists are working in academic medical centers which are centralized in urban areas and often away from our patients,” Marisa McGinley, DO, assistant professor of neurology at the Cleveland Clinic Lerner College of Medicine, said in her presentation.
Neurologist shortages in the United States are concentrated in micropolitan centers rather than metropolitan areas and rural regions instead of cities or exurbs, and are centered on issues of insurance availability and access for multiple underrepresented populations who have certain comorbidities.
The region of Appalachia, McGinley said, has health care access ratios 25% to 30% lower than other regions in the U.S. due to low socioeconomic status and being a rural area.
In addition, Black and Hispanic patients with neurological conditions are 30% to 40% less likely, respectively, to see outpatient neurologists compared with white patients.
McGinley proposed utilizing technology to overcome these issues.
The rise and success of telemedicine both immediately before, during and immediately after the COVID-19 pandemic showed that simple screen time could increase access, minimize disruptions to health care, reduce the financial burden on patients and the system alike. Evidence most strongly supported the benefits of teleneurology in single visits, buffeted by patient satisfaction for those with MS.
However, she noted, issues of technological access also plague the aforementioned areas and affected populations, and those who require specialized care often had to find ways to venture to those who could treat neurologic conditions best.
To address knowledge gaps across the treatment and socioeconomic spectrum, McGinley and colleagues initiated the ongoing Virtual vs. Usual in-office care for Multiple Sclerosis (VIRTUAL-MS) randomized clinical trial.
Researchers will attempt to determine whether MS care delivered through telehealth is non-inferior compared to in-clinic care, measured at 2 years by disease worsening according to the Multiple Sclerosis Functional Composite, as well as by patient satisfaction and non-medication costs of treatment.
An increasing concern in treatment and telehealth spaces, equitable health care models depend on expanding broadband access, addressing issues unique to each community and population which requires access, improving digital literacy once access is gained, while attending to addressing socioeconomic factors which drive these disparities.
“There are policy and organization changes that are needed,” McGinley said. “There’s clear data that there’s a need to develop health care models that address access and access needs for people with MS.”