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Mobility to bring healthcare services closer to people

Have you ever had a medical emergency and had to travel long distances for your treatment? Or are you close to a doctor but unable to set up an appointment? If any of these scenarios sound familiar to you, the most probable is that you are living in a medical desert.

Medical deserts

In the Ile-de-France region, 62.4 % of the population is now in the \”red\” zone. Due to a lack of consultation appointments, more than one in every two French people has gone without seeing a general physician.

The goal of healthcare policies is to provide universal health insurance for all citizens. Even in countries where the total number of doctors is higher than ever, ensuring universal access to basic medical services is difficult. Medical deserts are usually present in rural and remote areas, but they can be seen in developed areas as well. This term, as we already mentioned above, is used to describe areas where people have insufficient access to healthcare. Despite the implementation of schemes and measures in rural areas, the situation usually does not have some tremendous changes.

Medical deserts are also a sign of an outdated healthcare system that is no longer appealing and has failed to recreate itself. Nowadays, upstream digital solutions are required to organize, filter, control, and as such outsource and preserve private practices, saving actual medical time.

Issues

Medical deserts can have a negative impact on the health of people who live in rural areas. Large geographical distances, combined with the reduced mobility of the older population and fragile patients, intensify the issues. Long queues for appointments stimulate people to ignore symptoms or miss screening tests, potentially harming their general health and possibility of rehabilitation. Medical deserts also cause an overburdening of healthcare emergency personnel, especially for care which can be offered by general practice.

Healthcare improvement with digital technology

Technology has become an integral part of managing patient care, staff procedures, and office efficiency. Journal entries in medical charts, doctors using audio recorders to write things down, and personnel needing to use a desk phone to make the call are all things of the past. Everything is digital and mobile in the present era.

Access to information at any time and from any location is driving demand for personalized service delivery in every industry, including healthcare. However, increased demand does not lead to increases in available resources. This pressures personnel to make the efficient use of limited reserves in order to deliver the necessary healthcare services. From aging populations and lack of personnel to rapidly increasing expenses, healthcare experiences complex challenges. These constraints put a huge strain on organizations, medical specialists, health care workers, patients, and so on.

Healthcare, like many other sectors, is trying to look for workable solutions. Healthcare professionals look forward to digitalization and technology to help them to overcome their workflow.

There are three main factors driving investments in clinical mobility: strengthening patient health care, cutting down the cost, and improving the healthcare professionals’ workflow performance.

Healthcare facilities and providers are expected to provide immediate access to health data from any device while also ensuring data privacy and confidentiality and providing the health service as well. There are numerous challenges. Although with asynchronous messaging and paramedical teams, the mixture of technology and humans can multiply medical capacities, there are still a certain number of challenges regarding mobility in the ecosystem of healthcare.

Clinical mobility – efficient solution for medical deserts

Telemedicine and telehealth have enormous potential for improving access to healthcare. The use of digital information and innovative technology can help bring care to rural areas. Most remote regions, moreover, lack a reliable and fast connection to the internet. Therefore, this could be a challenge that needs to be addressed in clinical mobility as well. It is also critical to ensure that both the older population and healthcare workers understand how to use innovative tools for patient care. The problem and challenges are defined, but what solution would be the best?

A group of four students at Côte d\’Azur University (France) : Nathalie Gaio, Annie Joanno, Guillaume Perrier and Maxime Rame, together with their mentor Barbara Moigne conducted a study on the deployment of a medical vehicle in the Niçois hinterland in France.

The project went under the name “HEALTH CARe,” and it consisted in carrying out a feasibility study on the implementation of a vehicle equipped with the Health Lounge health kiosk from Bodyo to allow people with no easy access to healthcare and living in rural areas to get a full health checkup and access to a general practitioner or a specialist from the Nice General Hospital via teleconsultation. Health checkup data includes biometrics such as height, weight and body mass index, but also body composition, blood oxygenation and cardio-vascular data from oximetry and blood pressure.

This study was conducted on three aspects: demographics, regulation, and economics. The overall objective was to identify the needs of the populations to confirm the necessity of deploying a healthcare vehicle. Moreover, this project was carried out in the Alpes-Maritimes and served as a model on how to extend its deployment. After studying current regulatory and demographic issues, was suggested a loop route for the vehicle that would cover 13 villages over a period of 20 working days to carry out health checkups on 5% of each village\’s inhabitants. It was considered that the driver, a health professional who would also accompany patients, would work 7 hours a day, 5 days a week. The time of presence in each village was determined according to the number of inhabitants, ranging from half a day to 3 days. For villages requiring a half-day presence, another half-day was planned in a nearby village to optimize travel time. Regarding the duration of the consultation, it was counted 10 minutes for a basic health checkup and 20 minutes for a teleconsultation. After interviewing health professionals (such as Dr. Renaud David, neurologist at the General Hospital in Nice), the optimal health checkup frequency was set to once every three months for patients with no pathology.

This study led to the conclusion that clinical mobility solutions would be a proper tool for health professionals to provide optimum healthcare services to patients, on top of the added benefit of mobile flexibility.

Future development

Many countries are grappling with how to ensure access to adequate medical services for all, particularly those living in rural and remote areas, in regard to aging populations and urban development. As a result, efforts are being made to improve the geographical distribution of doctors. These include, among other things, financial incentive programs, university curriculum intervention, the creation of new professions, and the development of coordinated practices, but the future accent is put on increasing the use of telehealth and telemedicine.

The fast-paced growth and innovation in the healthcare transportation sector reflects the longstanding need for progress in this area. With the already mentioned aging population, it is likely that the number of people relying on external transportation provisions to healthcare facilities will grow. The realization that transportation barriers to healthcare access are often preventable has dovetailed with the proliferation and familiarization of shared mobility technology in the world. Shared mobility can provide a viable option for populations with specific needs or barriers (e.g., older adults) and will continue its transformative impact on transportation access broadly.

Important shifts in healthcare delivery have contributed to creating an environment ripe for change. Healthcare transportation, like the rest of the healthcare industry, is moving increasingly into the digital age.

Considering the effectiveness of measures implemented by some countries provides valuable information for future development. However, more needs to be done to address a situation that is expected to worsen in the future. Customized approaches to combating territorial inequalities that consider various dimensions, both territorial and individual, appear to be the most promising. Furthermore, various prevention and early disease detection strategies must be implemented in order to reduce the overall burden of diseases and future healthcare demand.

Katarina Petkovic

Sources

  • https://www2.deloitte.com/us/en/insights/focus/future-of-mobility/transforming-health-care-improving-patient-experience.html
  • https://www.euro.who.int/__data/assets/pdf_file/0006/248343/Health-Professional-Mobility-in-a-Changing-Europe.pdf
  • https://medicalcourier.com/six-reasons-you-should-implement-a-clinical-mobility-solution/
  • https://epha.org/medical-deserts-a-growing-problem-across-europe/
  • https://www.zebra.com/content/dam/zebra_new_ia/en-us/solutions-verticals/vertical-solutions/healthcare/white-paper/2022-hospital-vision-study-en-global.pdf
  • https://bmcpublichealth.biomedcentral.com/articles/10.1186/s12889-020-08803-5