December 4, 2022

In rural markets, implementing telehealth and other digital health solutions is an uphill climb.

Access to broadband, primary care physicians and hospital care is markedly lower, but there’s a growing consensus that existing rural providers can yield innovation and adoption.

A study released by Rock Health, a research and digital health venture firm, revealed the deep-rooted barriers with adoption. Only 36% of residents have used live video telemedicine compared with 64% of those who live in urban areas.

“Rural respondents, compared with the urban and suburban, were using less telemedicine,” said Dr. Natsha Din, a physician and one of the study’s co-authors. “They were trusting the clinicians more than online information websites.”

According to the analysis, rural residents use digital health tracking solutions 20 percentage points less frequently than their urban peers. For wearable use, there is an even more significant gap.

The gap has been present for the past few years.

Din and the study’s other authors said poor cellular connections and a lack of broadband internet contribute to lower adoption.

Since experts say technological advancements would not fully remedy problems in access, companies are beginning to identify partnerships to improve patient outcomes and digital health adoption.

Adriana Krasninsky, research manager at Rock Health and one of the study’s co-authors, said building trust is an important part of increasing adoption through partnerships.

“How are you really going about this in a way that continues to lead with trust,” Krasinsky said. “Some of those components are already part of the rural care ecosystem, such as a community pharmacy.”

That’s where Homeward, a start-up provider targeting rural communities with mobile clinics and at-home care, is going.

Through a partnership with RiteAid, Homeward is seeking to improve access to care by using mobile clinic vans that provide primary care services including annual wellness visits, screenings and risk assessments in rural communities. It will also provide virtual care services to these patients as well, and refer them to regional health systems for more complex care. The service will be delivered to Medicare and Medicare Advantage members.

Homeward’s vans will be parked at select rural Michigan RiteAid locations beginning this summer.

“Pharmacists are incredibly trusted individuals in any setting, but particularly in rural settings,” said Jennifer Schneider, Homeward’s CEO. “They have a really high percentage or number of touchpoints running into any individual person.”

Schneider is the former president of diabetes digital health company, Livongo Health, which was acquired by Teladoc in 2020.

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Homeward seeks to engage patients via vans parked at Rite Aid pharmacies. After engaging with a patient, Homeward can provide virtual care follow ups. The company will augment care with cellular-based remote patient monitoring that is able to share patient data with providers.

“Implementing the technology is not the hurdle,” Schneider said. “The technology today is fairly ubiquitous, and we have had good experience with adoption.”

What does slow progress is the drawn-out implementation of value-based care among payers, she said. Owning the total cost of care allows Homeward and others to mitigate problems associated with scale.

Still, others aren’t convinced.

“For any home care-based platform it really comes down to having enough density to justify the cost and the overhead to launch that market,” said Dan Trigub, CEO of MedArrive, a virtual care and in-home health services provider.

By partnering with Rite Aid, Schneider said she hopes to increase density by engaging with residents at touch points already in the community.

Still, investing in digital health platforms tailored for rural residents remains nascent and an upward climb.

“I think it’s an interesting area for digital health innovators, simply because it’s been a hard nut to crack,” Krasninsky said. “That leaves opportunities, especially as we think about different models and care arrangements.”

Those opportunities might take time to be profitable. Chris Bohrer, the senior vice president of payer and strategic initiatives at Rite Aid, said he expects the partnership to increase adherence by driving customers to its stores more frequently.

“It’s about how do we create value in the system and ultimately the money will come,” he said. “Rite Aid makes money when people are adherent.”

Bohrer said there are no concrete plans to roll out the partnership in other markets.

This story first appeared in Digital Health Business & Technology.

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