People Want Access to Quality Healthcare. So, Let’s Talk about What “Access” and “Quality” Really Mean.

There is a lot of discussion about healthcare access these days. But what does that really mean? 

Some say the key to improving healthcare access is to ensure clinics and hospitals are a short driving distance away for all people, whether they live in the heart of a population center or in more rural and remote areas. Others argue that the key to ensuring equal access to quality healthcare is offering a universal health plan or affordable insurance coverage that enables everyone to seek care regardless of financial means.  

However, at least from my perspective, access is about far more than one’s proximity to a care facility or the ability to pay medical bills. Even if there was a full-service hospital every 30 miles and no charge for care, that doesn’t mean it will automatically be possible to provide quality care to every person who seeks it. There are other factors that impact the types (and quality) of care they’ll be able to access both in person and virtually. 

That’s why it’s important we look at healthcare accessibility from a slightly different lens: 

• Is there enough staff to accommodate all patients? And how do we improve staff availability for increased caseloads each day if/when we can’t increase headcount?  

• Can clinicians see patient histories and share current treatment protocols with other physicians to ensure continuity of care and, therefore, access to quality care?  

• Is compliance with the five rights of medication administration guaranteed across current healthcare system processes? 

• Can nurses reach doctors – or primary care physicians reach specialists – when consults are needed? Is there a way to successfully conduct virtual consults without compromising patient outcomes? 

• Are the supplies, medication and medical devices needed to care for patients with varying ailments available right now? 

We must also remember that healthcare access isn’t solely defined by the ability to book an in-person appointment or receive emergency care in a timely manner. There are other access considerations, too. 

• Will access to patients’ medical records – and, therefore, their privacy – be protected?  

• Will they receive telehealth access to care team members as needed for consults or follow ups? 

• Will at-home treatments be manageable…and accessible? Or will they struggle to get the medications and medical equipment they need via local or mail-order suppliers? 

In other words, we need to broaden our dialogue around healthcare access solutions. We must also be careful not to associate care quality with the use of advanced medicine or cutting-edge devices – at least not exclusively. Even basic operational processes influence the patient experience, such as how staff manage supplies inventory, identify patients, and share their information. That’s why healthcare leaders must look for the issues that may impact care delivery in some way and take tangible steps to address them. Otherwise, patient access to quality care could decline, even if they only live a mile away from a top-rated hospital. There may not be enough specialists to serve them or a way to ensure they’re receiving the right lab results and medications. 

What’s Challenging Access to Quality Care Today 

There are more than 664 million people in Latin America and the Caribbean today, and millions more who travel to the region for medical care each year. This puts local healthcare systems under tremendous pressure to sustain a high quality of care amid extreme demand. Even in areas where healthcare investments are growing and healthcare is readily accessible, resources aren’t readily available for patient surges. And there is still a significant reliance on legacy processes and systems across the region, which means information systems and communications are often fragmented and unsecure and workflows are slow and sometimes manual. As a result, many healthcare providers struggle to… 

• maintain continuity of care between primary physicians, specialists, and ancillary care providers. 

• improve patient flow and bed turnover rates. 

• identify patients and connect their processes with their medical histories. 

• locate equipment, supplies and people in a timely manner. 

• manage administrative processes like invoicing or asset management. 

• “be here now.”  

Clinicians are constantly distracted, often by the need to chase down information, people or equipment, sometimes their own worries. Even administrative staff at Latin American hospitals are overburdened and unable to complete their work during their shifts, according to 75% of hospital decision-makers in the region who recently participated in Zebra’s latest Healthcare Vision Study. 

All this combined makes it difficult to give patients access to quality healthcare, even when they have financial or physical access. 

I realize these are pains shared by the global healthcare community, but we must take action as a region to identify the underlying reasons for these struggles. Once we do, we should look at the policy, process, and technology solutions our peers in other regions are using to see if they will serve us well too – with the understanding that we must also consider local resource challenges and patient expectations. 

What Can You Do? 

We recently asked healthcare leaders in Latin America to conduct a self-assessment of their challenges and offer thoughts how greater digital maturity could help overcome those challenges. Though each country is driving progress to digitalization at a different pace, and each healthcare system has a unique set of priorities, the consensus is that more can and must be done to support staff and patients via technology.  

Fortunately, one of the easiest ways to improve staff availability and capacity is to digitalize workflows. How? By giving doctors and nurses company-owned clinical smartphones or tablets equipped with software applications specific to their roles and then giving non-clinical staff company-owned enterprise mobile devices (also loaded with software specific to their roles). The emphasis is on “company owned.” Why? Because you can’t control information flows or system access if staff are using their personal devices. It’s just too complex. You need to be able to sync all devices on the same apps and systems so staff can easily communicate with one another in a secure fashion and information while alerts and assignments can automatically flow to the right person. Once staff have full “computers” at their fingertips, no matter where they are in the facility, you’ll see their productivity and efficiency skyrocket – and that’s the key to seeing more patients. Of course, clinical mobility’s benefits will be somewhat limited until all data is digitized. That’s why the adoption of an electronic health record (EHR) system is so critical. 

However, it’s important to choose an EHR system that allows interoperability with other processes so clinicians can see patient histories and share current treatment protocols with other physicians to ensure continuity of care and, therefore, access to quality care. If it’s only locked down to employees – the data isn’t centralized at a facility, country or regional level – then patients who move around will still be responsible for managing their care. If they don’t carry paper records to every appointment, then physicians won’t have a full medical history to inform their diagnostic or treatment orders. Even if a patient is diligent and brings their records, doctors don’t have time to review them on the spot. That can take up the whole appointment time (if routine) or delay action in critical care scenarios. And if a patient comes in through the emergency department, they may not be able to communicate their medical history. That’s why it’s imperative for EHRs to be widely used and shared as appropriate.  

Once the digital system is in place, though, it’s just as important that care team members can securely access and update EHRs while on the move, thus the need for a clinical mobility solution. With a secure, well-connected mobile computer in hand, staff will be able to scan ID cards and wristbands for positive patient identification (PPID), pull up patients’ EHRs, do a quick search/review and then put together an action plan. If a diagnosis is confirmed or labs or medications ordered, the EHR can be immediately updated so the next care team member who sees the patient has the latest information. 

Implementing location technologies such as radio frequency identification (RFID) and Bluetooth® Low Energy can be game changing in terms of supplies – and supply chain – management, which we now know directly impacts care delivery. In a matter of seconds, staff can see what’s available in the facility and where exactly it’s located. They’ll also be able to verify that medications or medical devices are still good to use – that they haven’t yet expired or been part of a recall. Additionally, as they use supplies, prescribe medications, or notice a need to replace equipment, replenishment requests can be submitted instantly to procurement teams. This automated tracking of inventory utilization helps prevent out-of-stocks that can hinder patient access to quality care. In fact, these solutions can be deployed in all pharmacy settings – and throughout the entire pharmaceutical supply chain – to help build ensure medication availability, safety and quality, all of which impact patient outcomes. Watch this: 

We’ve also seen RFID used in not-so-obvious ways to improve hospital operations, such as for laundry services. What does linen have to do with access to quality healthcare? Well, if there aren’t clean linens available, it will limit service capacity or lead to unsanitary conditions. Additionally, inefficient laundry management leads to excessive expenses. And that’s money that could be used to hire more staff, buy more medical supplies or make other improvements that would make healthcare more accessible to more patients. 

What to Remember When Trying to Improve Care Access

Clinical care models are no longer confined to clinics and hospitals. The doctors and nurses may be located there, but patients may be at home. Or the patients may be in hospitals and the physicians hundreds of miles away. Therefore, changes made to improve care access must account for telehealth and remote patient monitoring – both inside and outside the four walls. Again, making sure the EHR system can be securely accessed by care team members on mobile devices will be an important first step. However, enabling real-time communication and diagnostics with distanced patients will be just as important. That means that healthcare IT teams must look at their wireless network infrastructure to confirm there is enough bandwidth to support constant data and video streams between devices, as solution engineer Hector Meza called out in this recent commentary:

Healthcare IT Teams Must Consider Today’s Technology Limitations When Planning for the Future 

And healthcare providers must consider how they will give patients access to medical records and test results and collect data from digital health devices that patients use in their daily lives. These three interviews are worth the read when you have a few minutes:

• The Future of Telehealth: Virtual Appointments Aren’t Going Away, but the Real Opportunity to Improve Outcomes Lies in Virtual Clinician Collaboration

• Ask the Experts: Telehealth Helped Sustained Patient Care During the Pandemic. But Will There Be Sustained Demand Once Its Over?

• The Future of Telehealth: Virtual Appointments Aren’t Going Away, but the Real Opportunity to Improve Outcomes Lies in Virtual Clinician Collaboration 

This means that you may need to collaborate more with healthcare providers you would have previously considered competitors to ensure information system interoperability, expand your service offerings, or share supply chain resources. At the end of the day, even if you’re a for-profit healthcare facility, you’ll only see revenue come in if you have patients coming in. And if you don’t have the staff, supplies, equipment or other resources to book more appointments or surgeries, then what good will it be to remain in a silo? 

Also worth noting: the cost of not increasing technology utilization could far exceed the costs of deploying fundamental clinical mobility and locationing solutions. 

In fact, one of the main reasons why Swiss Medical Group in Argentina implemented its RFID laundry solution many years ago was because it was costing too much not to improve linen traceability. It needed to get control over what was being sent out and coming back in so it could control costs. Watch this:

Finochietto Medical Center was in a similar position when it implemented RFID to improve its laundry process and improve the safety of patients and staff:

Beyond the obvious cost savings and opportunities to reallocate spend elsewhere, there are both tangible and intangible costs to delaying healthcare’s digital maturity – and benefits to accelerating it. As one Latin American Chief Medical Information Officer (CMIO) pointed out in our recent regional assessment, communication between clinicians must improve, as must the use of staff and resources. There are too many reports of patients being left in ambulances waiting for specialists or interventions being delayed within the four walls because doctors and nurses can’t be reached.

The EHR is great, but it could be mobile. The clinical mobility solution is what makes that digital patient information accessible to clinicians at the point of care. It’s also what enables the easy movement of clinicians and patients from one floor, department or facility to the next.

If you need to relocate staff or patients during surge periods, you can. The clinical mobility solution can make it easier for care teams to set up new points of care without compromising patient safety. The mobile device can be used for PPID, retrieving digital records, enabling virtual consults, ensuring the five patient rights are protected during medication administration, and coordinating diagnostic and treatment plans from literally anywhere there is a secure wireless connection. Additionally, care team members can keep their attention on patients, which helps to improve outcomes and increase turnover. Every step taken to go to a central workstation is a wasted step. Similarly, every technology device that goes unused is a wasted investment, which leads me to my final point.

No matter what technology you deploy, make sure you ask those who will be using or managing it if they agree with your strategy and solution design. As we have seen in Brazil and other Latin American countries, technology doesn’t always solve problems. And when it doesn’t, it’s because it’s the wrong device or software for the job, therefore making the end user’s job harder. If you want to ensure you’re making changes that will improve staff efficiency and availability, run a pilot, and ask clinicians if certain technologies are helping them complete basic tasks such as patient data collection faster than before. Measure the performance and ergonomic differences between mobile devices, wearables, scanners, and other devices. Test the user experience for new apps to see if the workflow is easy to follow. If it’s taking longer for a clinician or other staff member to complete an action using the technology, that’s further limiting access to quality care – not improving it.

Let’s Drive Positive Changes Together

If you’d like to learn more about how different technologies can be used to improve staff efficiency, patient communications and overall healthcare access, our healthcare team would be happy to speak with you. You can contact us here.

Additionally, you may find these resources helpful:

• Clinical Mobility and Healthcare Digitalization Around the World: An Approach to the Latin American Context
• Global Healthcare Vision Study: Smarter, More Connected Hospitals

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