The many dimensions of access to care

Piali De, CEO

These days, I often find myself thinking about the tragic impacts of poor access to health care. I find my mind wandering between four obstacles to good care: geographic, specializations, economic, and frequency. 

The most intuitive lack of access is because of geographic challenges, experienced by those who live far from care or with inadequate transportation options. Related to geographic access is the constraint posed by lack of physicians in our communities with the specializations that our healths need. Physician specialists are increasingly clustering in large metropolitan areas, far from where most of us live. 

The third obstacle to good care is economic. Even if we have health insurance, numerous costs such as copays, deductibles, prescription costs add up to interventions that many cannot afford. Healthcare costs for interventions add up like a death with thousand cuts.
 
The last obstacle to care is the one that is least intuitive but matters most to those who struggle with chronic conditions. The frequency of the support we get from our physicians is critical to stable chronic health. We know that when it comes to managing our chronic health, five visits with our PCP is more beneficial than the financially equivalent single visit to the ED for an unmanaged exacerbation. To take this one step further, what if we could receive daily support with managing our chronic health in addition to the occasional visits to the doctor's office? Our Ibis Program shows that daily support - 4 minutes per day on average - results in more stable physical and mental health, resulting in far fewer ED visits and hospitalizations. And whereas health care delivered daily to the home was unimaginable decades ago, today it is easily done through digital means  and will soon become standard for chronic care. Or so I hope.