Wednesday, August 3, 2016

If the Law is Careful, Rural Healthcare Could See a Complete Overhaul

By  LXBN | August 3, 2016
Economists and health experts have known for years that a society’s level of inequality can lead to a disparity in healthcare. But now we have the tools to help—that is, if the law keeps up.
On Tuesday a company called Zipline, which uses drones to deliver medicine and blood, announced that the White House had asked if the company could start delivering in three U.S. states. Like their work in Rwanda, Zipline would be delivering to rural areas in Maryland, Nevada, and Washington via their aircrafts, called “Zips.” They can fly at speeds of up to 60 miles per hour, can carry up to three pounds, and can fly 75 miles on a single charge.
Once hospitals order blood or medicine via text message, the plane navigates using GPS and cellular networks and can make deliveries via parachute in under 30 minutes (which negates the need for refrigeration).
“When you look at rural or isolated communities, particularly Native American populations, populations that live on islands, you have serious health outcome inequalities. There’s a linear relationship between how far away you live from a city and your expected lifespan,” said Keller Rinaudo, Zipline’s founder and CEO in The Verge. “People think that this is impossible and completely wild. And the reality is that it’s completely possible and in fact, it’s vastly simpler.”
Or at least it can be. Part of the reason the company launched in Rwanda, one of the poorest countries in the world, is because of the strict regulations, safety concerns, and technical challenges that have made routine package delivery in the U.S. so difficult. Everyone from Amazon to Dominoes is trying to get in on the drone game, but the FAA has had a tangled road to the simple rules they announced in June.
Under those new rules, Zipline will have to apply for a waiver to the FAA regulations, and expects to begin operating within six months of receiving it (about a year from now, hopes Rinaudo). They aren’t the first drone company to do it, but their alliance with the White House seems to suggest that they’re the most successful.
Which is a good thing because people need better healthcare all over the nation. Several studies have shown that rural populations—in addition to being, on average, older, poorer, and with fewer physicians—experience significant health disparities from their urban counterparts. People live longer in the “more equal” states. Things like hypertension, food stamps, alcohol and tobacco use, fatal motor vehicle collisions, and more all present at a higher rate in rural areas. But though nearly 25 percent of the U.S. population lives in rural communities, less than 10 percent of physicians practice there (and even fewer dentists).
The Obama Administration clearing the runway for drones making medical deliveries could be a big help in these communities. It’s the same changes that are being made in the telemedicine world by the AMA, as Lisa Schmitz Mazur and Shelby Buettner wrote on Of Digital Interest:
Consistent with past guidance from AMA and other professional organizations, the AMA notes that the ethical responsibilities of physicians are the same – regardless of whether the physician communicates with a patient in-person or remotely – and encourages providers to recognize the potential uses and limitations of technology when delivering care. “Telehealth and telemedicine are another stage in the ongoing evolution of new models for the delivery of care and patient-physician interactions,” said AMA Board Member Jack Resneck, MD. “The new AMA ethical guidance notes that while new technologies and new models of care will continue to emerge, physicians’ fundamental ethical responsibilities do not change.”
…Notably, the 2014 guidance required that a patient-physician relationship be established prior to the provision of telemedicine services. The relationship could be established during a face-to-face examination, through a consultation with another physician, or by meeting the evidence-based practice guidelines developed by major medical specialty societies. While the 2014 guidance did not specify whether the face-to-face examination must occur in-person, rather than digitally, many interpreted this requirement to be satisfied via an interactive telemedicine encounter.
In addition to that, several states like Rhode IslandAlaska, and Louisiana have taken steps to create normalcy and access for telemedicine this year. Though the tide seemed to be shifting in 2015, telemedicine has really come to be seen as an answer for connecting rural communities to healthcare.
That is, if the law can stay out of its way. Obviously no one wants improper care being dispensed through telemedicine visits or medical delivery drones getting in the way of aircrafts. But if the law can keep balance between a light and firm touch, these technologies could help a lot of people. If rural communities can count on this connection to not be languishing in FAA purgatory, that could make a world of difference.

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