Healthcare was not historically designed to serve the most vulnerable patient populations. Today, patients might not engage with healthcare due to lack of insurance, work or family obligations, or other kinds of inaccessibility. However, telemedicine services like video consultations and at-home diagnostic testing can improve access to care and quality of care for elderly patients, patients in rural communities, those at risk for HIV, and specialty care patients in need of screening programs.  

Why is access to care an issue?

There are different barriers to care that make it difficult or impossible for patients to access high quality medical treatment in a timely fashion. These include foundational issues of financial inequality, such as the inability to afford treatment or medication, as well as problems with transportation or specialty care shortages in certain areas of the United States. Access to timely preventative care improves patient health outcomes and reduces long-term care costs. The widespread adoption of telehealth video chat cuts down on wait times, while the integration of remote services such as at-home diagnostics allow patients to access other aspects of the care cycle from home.

Improve care for elderly patients

Telehealth services can improve quality of life and access to high-quality care for older people. According to a 2021 review of literature, “convenience and affordability [are] the strengths of telehealth use in geriatric care,” as well as safety. Safety concerns include exposure to disease with in-person care or mobility issues associated with transportation to and from healthcare settings. 

Some of the benefits of remote care for elderly patients include:

• Less risk of serious events such as fall
• Service to patients from rural communities
• Reduced overcrowding in health facilities
• Personalized management, including reminders

With advancements such as at-home diagnostics, elderly patients can complete a remote care cycle without engaging with a phlebotomist or visiting a lab. Americans 65 and older can complete many recommended health screenings, including diabetes, kidney problems, and heart disease.  When hospitals and clinics invest in telehealth and at-home diagnostic testing, geriatric patients — no matter their location — can more actively engage in healthcare. 

Offer at-home PrEP services with dried blood spot cards

Men who have sex with men and other at-risk populations for HIV can use telehealth services to complete necessary labs for ongoing PrEP medication adherence.  At-home PrEP testing offers enhanced accessibility, benefiting those with limited access to traditional healthcare, such as shift workers and parents. PrEP adoption in the United States has risen by 73% since 2012, but 40% of PrEP users discontinue the medication within two years. Remote HIV testing and PrEP maintenance services aid public health departments and community organizations in fulfilling grant obligations, ensuring continuous support for individuals and sustaining the upward trend in PrEP utilization. 

Providers can offer dried blood spot cards to conduct routine labs for creatinine levels and HIV. PrEP users complete screening through the following steps. 

Step 1: Order Kit

Patients schedule PrEP labs through a digital health service, or a provider sends one after a telehealth consultation. The kit will be discreetly delivered.

Step 2: Collect Capillary Blood

After carefully reading the instructions, patients use the provided lancet to prick a fingertip. Patients allow a small drop of blood to form, and then blot it onto five 13 millimeter circles on the DBS card. 

Step 3: Let it Dry

Patients place the DBS card in a clean, dry area, and let the blood dry completely. The fibrous matrix of the card will absorb and preserve the blood samples.

Step 4: Ship to Certified Telemedicine Lab

Once the blood is dried, patients use the prepaid shipping materials provided in the kit to send the DBS card to a CLIA/CAP certified telemedicine lab. 

Step 5: Laboratory Analysis

At the lab, skilled technicians will punch out the dried blood circles and extract target analytes using a liquid solvent. This process allows for accurate analysis of HIV markers. The technicians will perform the necessary tests to determine results.

Step 6: Physician Review and Follow-Up

A certified physician will review results, and patients will receive them within 3-5 days after the lab receives the DBS card. If necessary, the physician will follow up to discuss the results and prescribe additional care.

Implement population screening for cancers and diseases 

Not only can telehealth services help boost adherence for medications that require routine testing, but at-home diagnostics can also screen vulnerable patients for a wide variety of cancers and diseases. Payors, clinics, and hospitals can improve their HEDIS and Star ratings with remote screening programs that target those at risk for diabetes or colorectal cancer.  

HEDIS measures offer guidelines for Comprehensive Diabetes Care (CDC) for patients 18 to 75 years of age with diabetes type 1 and type 2, which includes Hemoglobin A1c (HbA1c) testing. A pivotal aspect of diabetes care involves regulating blood glucose levels, reducing the risk of complications, and enhancing patient longevity. In the absence of adequate management, diabetes may lead to serious complications, including heart disease, stroke, hypertension, blindness, kidney disease, nervous system disorders, amputations, and premature mortality. At-home diagnostics programs remove transportation barriers to care for vulnerable patients like shift workers and parents who require diabetes screening.

Population screening programs also enhance Star ratings. For example, the U.S. Preventive Services Task Force recommends screening individuals aged 45 to 75 for colorectal cancer. The remote FIT test, a non-invasive at-home screening method, identifies human blood in stool from the lower intestines, indicating potential colorectal cancer or gastrointestinal issues. This screening process involves patients collecting a small stool sample at home and sending it to a lab for analysis.

Chat with Ash Wellness about remote HbA1c and FIT testing. 

Improve access to care for patients in rural areas 

Telehealth was first developed to deliver fundamental care to individuals in rural and underserved communities, as outlined in a study published in The Journal for Nurse Practitioners. Sparse populations in remote regions of the United States often result in fewer available businesses and services, including healthcare facilities. Consequently, residents in these areas face elevated risks of mortality from diseases such as heart disease, cancer, lung disease, and stroke, along with higher rates of obesity. Telehealth services remain instrumental in fostering more equitable access to healthcare for patients residing outside major metropolitan centers.

How Ash Wellness can help improve access to care for vulnerable patient populations 

Vulnerable populations such as elderly adults, at-risk HIV patients, and those in rural areas can benefit from telehealth services such as video chat and at-home diagnostics. Ash Wellness is the leading at-home diagnostics provider, offering innovative tools and end-to-end solutions for clients to launch and manage national testing programs. We provide white-label optionality to maintain brand integrity — from online order portals to physical test kits. Our network of providers, CLIA/CAP certified telemedicine labs, and secure lab API allows clients to pick and choose the best tools to launch and manage their screening programs.