Overcoming Ongoing Equity Challenges Through Remote Patient Monitoring

In part 2 of this interview, Jason Bellet, co-founder and chief business officer of Eko Health, explains how remote patient monitoring expanded care access, especially for underserved communities, during the COVID-19 pandemic and beyond. He also addresses the ongoing challenges in ensuring equitable access to remote patient monitoring and telehealth services.

Watch part 1 to learn more about the role of remote patient monitoring in health care before and after the COVID-19 pandemic.

This transcript has been lightly edited for clarity; captions were auto-generated.

Transcript

How has remote patient monitoring improved care access for underserved communities, especially in rural and low-income areas?

RPM [remote patient monitoring] and just telehealth in general unlock access to higher quality health care for patients in both rural and just generally underserved communities. I think we often think of the US as a pretty urban, well-covered country from a health care perspective, given we have some of the best health care in the world, but we often forget that about 50% of counties in the US don't even have a cardiologist. It's pretty mind-blowing to even think about that and that 50 million Americans live in rural areas hours away from the closest medical center.

The time that it takes to take off work and the cost that it takes, both in terms of time and real dollars, as well as having to drive to see a specialist, are incredibly prohibitive. In many cases, those specialists have weeks- or even months-long waiting lists. What happens is you have large percentages of the population who can't see providers. What telehealth allows us to do is to connect a patient in rural Alabama with a provider in Montgomery or in rural Alaska with a specialist in Anchorage in a way that wasn't really possible before.

It's sort of obvious, right? What we're seeing in our personal lives and our work lives and the power of video conferencing and working has translated directly into health care. The joke within health care is that it's always a decade behind everything else. Name one other industry that is still using fax machines or pagers.

Healthcare still is doing that, but the unlock that video conferencing has done in the professional environment that is allowing you and me to talk right now is beginning to open the floodgates in health care in terms of accessibility, particularly when we can combine it with tools, like Eko, that allow the provider to listen to the heart, listen to the lungs, and do a more comprehensive remote exam than you can just do over video conferencing.

What barriers still exist in ensuring equitable access to remote patient monitoring? How can they be addressed?

One of the biggest barriers was the reimbursement of RPM and telehealth in general. One of the reasons the floodgates opened on telemedicine during COVID was that there were a number of laws and rulings that were put into place that allowed systems to be reimbursed for a virtual visit at almost the same level, if not the same level, as an in-person visit. Of course, nonprofit and for-profit health systems need to get paid for their work, and providers need to be paid for their work.

That allowed providers to use their best judgment on what was in the best interest of the patient, to give them access to care, and of course, to be reimbursed for that. It's very important moving forward that that parity in payment be sustained. Otherwise, it could represent a really significant challenge for access to providers if patients are no longer able to leverage telehealth.

I think the second piece of it is more on the clinical side. A barrier to telemedicine is being able to provide the same level of care. Physicians and clinicians are in this work because they want to provide the best care possible, and so they feel that they're compromising on that because the patient is virtual and not in person in their clinic; that's difficult to stomach.

It's critical that we invest in technology that allows us to perform the same level of exams virtually as in person. Eko is an example of that with our digital stethoscopes. There are digital otoscopes, pulse ox [oximeters], and blood pressure cuffs. All of these things replicate what we would do in person but allow the patient to either record it on themselves or, in many cases, a medical assistant or a nurse to visit the patient's home, capture that data, and then send it back to a physician virtually.