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Bridging the Healthcare Access Divide

Auburn and Alabama business professors team up to pinpoint ideal locations for rural telemedicine health centers

 

Telemedicine

The world gets smaller as we use smartphones, tablets and laptops to communicate each day, touching every aspect of our lives. But can that technology aid in rural areas when someone needs to make a lengthy trip to see medical specialist?

Business professors from Auburn University and the University of Alabama have collaborated on research that could ease the state's healthcare access problem and give rural residents an alternative to traveling long distances to see that specialist.

Rafay Ishfaq, assistant professor of supply chain management in Auburn's Raymond J. Harbert College of Business, and Uzma Raja, associate professor of management information systems in Alabama's Culverhouse College of Commerce, applied supply chain and business analytics principles in research that introduces telemedicine to the public. Supply chain management involves managing all the activities that deliver products to the consumer in an effective and efficient way.

Ishfaq and Raja can identify suitable locations for rural telemedicine health centers that would maximize patient/disease coverage within limited public budgets, as well as medical service offerings and technology requirements.

Rafay Ishfaq

Rafay Ishfaq

"Telemedicine is a healthcare delivery mechanism for diagnosis, treatment and monitoring of patients where doctors and patients are separated by space, but mediated through information and communication technologies," Ishfaq said. "The use of telemedicine is typical in regions with large and dispersed rural population, much like in Alabama, where geographical, economic and cultural barriers have resulted in misdistribution of hospital-delivered healthcare services."

The research, "Bridging the Healthcare Access Divide: A Strategic Planning Model for Rural Telemedicine Network," was accepted for publication in Decision Sciences, an elite academic research journal.

"We can apply supply chain principles, such as demand forecasting, to healthcare by replacing the products with healthcare services," Ishfaq said. "The rural customers travel significant distances to get to retail stores for everyday purchases. These folks need access to healthcare facilities too, which are scarce in economically underserved rural areas."

Business analytics techniques can be applied to identify heath care needs in particular areas.

Uzma Raja

Uzma Raja

"The rural communities of the Black Belt region have specific healthcare issues," said Raja. "The ability to accurately predict the demand of healthcare services is critical while designing the rural healthcare infrastructure. The patterns of disease prevalence usually vary across various demographics -- gender, age, economic status and race. We used census data for county-level demographics and health survey data from U.S. Center for Disease Control. Using business analytics techniques on these two sources of large datasets, we developed estimates for prevalence of chronic diseases in the Black Belt region."

Ishfaq added, "You use these prevalence estimates and build on top of the logistical issues, such as access to facilities, service coverage and utilization of resources. That's what supply chain management is about. We do it in a product-based setting. Why not healthcare services?"

Ishfaq suggested that telemedicine centers could be located within county health care facilities.

"You can use technology to potentially connect local patients with specialists as far out as a cancer hospital in Houston or a heart specialist in New York City," he said.

He noted that rural residents' distance from many specialists could have an impact on the state's overall health.

"That's why we see so many chronic health issues in rural communities," Ishfaq said. "They come to a hospital in the city, they get treatment, they get the operation they need, and now it's time for them to go back. Can you imagine post-operative care and the regimen that needs to be with a person with depression or a heart condition? They need regular monitoring. A specialist is not going to travel to a remote location to see his patient.

"So here's a technology solution. You need to design that healthcare delivery system which incorporates logistical considerations. Where do you put your health care facilities? How far does a patient have to travel to get to that place? What would be the patient load at a facility that you don't overwhelm its resources?"

Raja said big data collection, storage and access has opened doors to "new research opportunities."

"In my decade-long research in business analytics, I have worked with large datasets to find solutions to problems in the corporate world," she said. "In this research project, we have shown how the same can be done in the public policy realm."

By Joe McAdory, Raymond J. Harbert College of Business

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Last Updated: June 4, 2014

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