- Hospital closures are symptomatic of broken healthcare infrastructure in rural America.
- Homeward, a healthcare startup, is using a hybrid model to pioneer a new way of patient care.
- This article is part of the “Innovation at Work” series exploring the trends and the barriers to workplace transformation.
Rural America is home to 46 million people, yet since 2010, the region has witnessed 140 hospitals close.
Of the remaining hospitals, over 30% of them risk similar outcomes due to inflation and workforce shortages. Though more patients have turned to telehealth in recent years, startups looking to remodel rural healthcare want to tackle another piece of the puzzle — the area’s shrinking healthcare infrastructure.
“Rural America is in the midst of a hospital-closure crisis,” Dr. Rishi Wadhera, the head of Health Policy and Equity at the Smith Center for Outcomes Research at Beth Israel Deaconess Medical Center and an assistant professor of medicine at Harvard, told Insider.
He said these closures make the situation more difficult for rural doctors, whose patients “tend to be older and have more chronic conditions.”
“While the growth in telemedicine will help address gaps in care for rural patients, we need to invest more in the healthcare infrastructure of rural areas, to ensure rural physicians have the resources and services they need,” he said.
A hybrid healthcare model for rural communities
Telemedicine’s rise in virtual-medical appointments not only enables physicians and patients to meet without risking COVID-19 exposure, but also increases access for patients who live far from hospitals.
Startups like Homeward Health are leveraging both in-person and telehealth models to support rural communities and their access to healthcare.
The company, which former Livongo executives founded this year, plans to use a mix of mobile clinics and virtual patient monitoring to simplify the healthcare experience.
Amar Kendale, Homeward’s cofounder and president, said he knew the company needed a multifaceted approach to serve rural America. “Technology helps with one piece of the puzzle, but given there are fewer and fewer hospitals and clinics, we also needed to address the infrastructure piece,” he said.
To support the area’s healthcare infrastructure, Homeward partnered with the retail-pharmacy company Rite Aid to provide mobile, on-site primary-care services at as many as 700 Rite Aid locations across rural America.
Kendale said Homeward’s network of mobile clinics can make healthcare more convenient for rural communities. “Now instead of driving 90 minutes to a hospital or clinic, which they don’t do until they are in a medical emergency, residents can get their medical check-up and testing in the community,” he said. “We can become part of their routine so that when patients pick up their prescriptions, medical practitioners can also give them in-person care.”
While Homeward supports virtual follow-up care and ongoing telehealth check-ins, the company also wants to prioritize specialty care and early crisis prevention.
Heart-disease care is one focus for Homeward because of the disparity in treatment between rural and urban patients. Studies have found that when presented with similar symptoms at a hospital, rural patients are less likely than their urban counterparts to receive cardiovascular care.
Kendale said Homeward plans to include heart disease as part of its comprehensive-care model when they open their first mobile clinics in rural Michigan later this year.
Technology ushers in an old-school approach
Under the Homeward model, a patient suffering from heart failure would have already been diagnosed in a mobile clinic instead of the emergency room, when it could be too late. Through Homeward, the system would virtually monitor the patient’s vitals, with the technology flagging the need for an in-home visit.
Kendale said new technology is bringing back medical practices from more than 50 years ago. “It is reminiscent of the traveling doctor who would make house calls,” he added.
In transforming the rural-healthcare model, Kendale hopes it will also change the roles of nurses, doctors, and other rural health practitioners. Studies have shown they worry about the quality of care they are able to deliver to their patients.
“Rural healthcare workers have seen their resources shrink, and so the burden has been falling on them,” Kendale said. “They have not had a lot of support. We hope this alleviates some of the workload and some of the burnout.”