Rural Areas: Diversity, Poverty, and Unique Experiences - Paper Example

Introduction

Rural areas are comprised of a myriad of diverse cultures, sects, and tribes that settle across the country, in the town of counties. The rural areas are unique, and a rural area in West Virginia is different from California's rural area (Borin et al., 2015). The rural areas are mostly occupied by poor people who live by hand and mouth. The poverty rates are high with statistics from the US Census Bureau showing that non-Hispanic, the rural black and the Hispanic are at high poverty rates compared to those living in urban areas (Borin et al., 2015). Due to the high poverty rates, among other challenges such as transportation, and communication, people in rural areas experience limited access to healthcare services. Despite the limited access to healthcare challenges, drone-telemedicine and telehealth technology offer the best solutions to overcoming the challenges. This paper discusses the limited access to healthcare in rural areas and the solution to overcome the problem.

Elements of the Problem

Limited access to healthcare services is caused by the remoteness of the geographical location of a patient. Some regions are far from the healthcare center, where they can access healthcare services (Nedungadi et al., 2017). Transportation is also a major cause of limited access to healthcare in various parts of the world. The government neglects remote rural areas and hence does not have access to good transport means that hinder healthcare workers' mobility. The transportation expenses in seeking medical appointments in the rise of chronic disease prevalence add costs to the poverty-stricken rural community members (Kim et al., 2017).

The number of healthcare centers is low following the rural hospitals' closure in the 1980s, leaving many rural counties without hospitals. The recovery process and the passage of the federal legislation to have to rebuild rural hospitals such as critical access hospitals have been slow. There is also the rising of Medicare reimbursement, which has greatly reduced funding through electronic medical records. However, the services have not been satisfactory since the healthcare centers still grumble over scarce resources that do not meet the local and regional public health infrastructure needs.

The poverty levels in the rural areas widely dominated by the blacks and a spike of other tribes and races are high. Compared to their urban counterparts, rural communities are more poverty-stricken. As a result, living in rural areas exposes the residents to a high risk of substantial health disadvantages. The employment rate is very low in rural areas, leaving the majority with no sustainable income source. Poor and limited access to healthcare is linked to poverty. Thus, people living in rural areas have low access to healthcare services.

In some regions, the number of healthcare workers is low; hence the few available can only treat or attend a few numbers of patients. The 2010 US Census Bureau shows that rural and remote population is 59 million people which represent 17% of the US population (Borin et al., 2015). However, the communities have only 16% registered nurses and 9% doctors (Borin et al., 2015). The data shows that the rural and remote areas experience an undersupply of the healthcare workers. Besides, medical specialists such as pharmacists, dentists, and nurse practitioners are few, leading to limited specialty care access. Thus, patients in rural and remote communities cannot access obstetrics and general surgery services.

Analysis

Limited access to healthcare means that there are few people receiving healthcare services in a large population. The rural areas are the most affected by the challenge due to various challenges highlighted above. The community members living in rural areas are highly enculturated due to various ethnic groups (Lee et al., 2014). As a result of population diversity, rural areas have varied beliefs, cultures, and values. The rural areas consist of immigrants from different races and ethnicities who are highly neglected by the government. Hence, access to healthcare services is limited.

Patients are the healthcare services consumers, and they face several challenges, among them is limited access to healthcare. However, people are disproportionately limited to access to healthcare for varied reasons. For instance, people living in rural areas face limited access to healthcare due to their geographical location and remoteness. Remote geographic location encounter shortages of the physician and workforce, limited resources, and small healthcare facilities. Mobility is a challenge since the transport means and accessibility are poor. Delivery of medicines and other essential healthcare services becomes a challenge. Besides, patients requiring urgent attention may not be effectively attended since poor mobility, and transport issues impede service provision. As a result of a conglomerate of challenges as mentioned, rural areas have limited access to healthcare.

Considering Options

Various intervention approaches have been employed to overcome the challenges relating to limited healthcare access. Telemedicine and telehealth allow the residents access services and connect with medical experts (Pratt, 2015). In such instances, patients do not have to travel long distances to meet the doctor or receive specialized or intensive care.

Another intervention is home-based care. The nurse located at the client's home makes an assessment and communicates the findings to the medical specialists who then give directions on care. Home-based health care enables patients to remain at home yet receive optimal health care services and improve their life and independence (Bhandari, 2014). The home-based healthcare comes with the addition of healthcare workers who treat the patients recuperating at home. Medical Home model has been used to offer the years in various states and has yielded results and utilizes a team of medical practitioners who ensure patients receive appropriate care when and where they need them.

The use of drones can also help deliver healthcare services in remote areas (Pirtle et al., 2019). Telemedicine and telehealth do not address transportation challenges since most people are old and receive healthcare from their homes with limited movement. To address the transportation of the medicines and essential equipment that the physician may need, drone-aided healthcare delivery and pickup services play a critical role. Using the drones, the routine test kits can be delivered, drugs refilled, and pick the patient’s exam kits like the urine and blood samples for lab tests. Drones are alternative to courier services and offer convenient and easy means of transportation.

Solution

No single option is best suited to address all the limited access to healthcare challenges in rural areas. Hence, this study proposes the use of a technological intervention comprising two elements. One is the use of drones for the delivery of tests, medicine, and other essential equipment. Second is the use of telehealth and telemedicine technologies (Pratt, 2015). Combining the two technologies is the best and most appropriate solution to limited healthcare services in rural areas. In the past years, technologies have widely advanced to become a widespread global consideration in healthcare delivery. Telehealth is a general term that implies telecommunication technologies to aid clinical health care delivery, education, and public health (Ware et al., 2017). The telehealth elements include remote patient monitoring devices, video conferencing, facsimile, and email.

The medical health professionals can consult and interpret the customer (patient) or the physician located in the rural area treating the patient through the technology. Telehealth technology bridges the gap of limited access to healthcare services in rural areas and people who cannot access health care due to other factors (Ware et al., 2017). The technology has been used by Medicare through their Medicare Telehealth coverage to easily allow the physician to easily carry out a virtual home visit. Statistics show that in 2016, more than 12% of the rural residents received part of their care through the Veterans Affairs (VA) telehealth (Pirtle et al., 2019). Telehealth technologies are preferred due to their reduced healthcare cost, as one does not need to travel to access healthcare services (Ware et al., 2017). Besides, it increases access to healthcare services to a place where the customers could not access care. Physicians can as cover a larger region attending to the customers virtually.

Ethical Implications

Although technology offers the best solution to the limited access to healthcare services in rural areas, the greatest implication of its use is ethical issues. Data privacy and confidentiality are a great challenge to the technologies used worldwide (Pirtle et al., 2019). The information is liable to hacking and misuse by people. The people in charge and responsible for the data can use the patients' information for other unintended reasons hence breaching their privacy (Pirtle et al., 2019). Hence, informed consent is an essential ethical practice that needs to be ensured when treating patients. Telehealth risks include an incomplete examination of a patient and miscommunication. Another ethical challenge is the impoverishment in remote areas, which deny some individuals access to the internet and, consequently, the technology (Pirtle et al., 2019). This disproportionate access to healthcare due to lack of internet connectivity is unethical.

Implementation

The implementation of the drone-telehealth/telemedicine technologies requires the use of the Kurt Lewin Change model. The change model has three stages: unfreezing, change, and refreezing (Hussain et al., 2018). During the unfreezing stage, the implementers create awareness of the technology's use and align the physicians and the rural people in one direction (Hussain et al., 2018). The change stage is the preceding stage after people have become motivated and accepted to have changed. The implementers introduce the new state of delivering healthcare services through drone-telehealth/telemedicine technologies (Hussain et al., 2018). The refreezing stage entails reinforcing, stabilizing, and solidifying the introduced change. It instills confidence that people do not revert to the previous traditional methods.

Conclusion

In conclusion, rural and remote areas experience acutely limited access to healthcare services, but this challenge can be addressed using drone-telehealth/telemedicine technologies. The use of technologies allows a limited number of the medical team to easily and timely carry out healthcare services. Drones are critical in delivering the test samples, medicine, refilling of drugs, and other essential physicians' requirements on the ground. The telehealth/telemedicine technology allows the physician to receive an interpretation of the tests such as scans, x-rays, and other imagery or any tests requiring the interpretation of the medical specialist. Implementing such technology requires using the Kurt Lewin change model that will allow the rural members to adapt to change and become well acquainted with the system.