5 takeaways from the Future of Rural Health Care Summit

Digital health experts from the public and private sectors gathered Tuesday at Sanford Health’s Summit on the Future of Rural Health Care.

The event, hosted by the Sioux Falls, South Dakota-based health system, featured a lineup of speakers from big tech firms and health systems.

Speakers were optimistic that providers at smaller, rural health systems could drive adoption of digital health solutions. However, they say challenges persist with trust and technology accessibility that could slow this process.

Here were Digital Health Business & Technology’s takeaways from the virtual event:

1. Adoption of digital health in rural markets offers challenges and benefits.

Leaders argued small, rural hospitals could lead adoption of digital health technologies because there are fewer barriers to implementation when compared with large, academic research hospitals. “Rural healthcare needs to flip the equation,” said Jim Weinstein, a senior vice president at Microsoft Health’s Innovation and Equity team. “It needs to be the model for this country, not the follower.”

While there is generally less red tape to slow digital health adoption in rural hospitals, technological challenges remain. Many advanced platforms require broadband internet that can be sparse in rural communities.

2. Providers face mounting competition—especially in primary care.

Gone are the days where physicians interact with patients solely in brick-and-mortar offices. The pandemic accelerated the need for virtual primary care. “Retail America vaccinated everyone—to this day you can’t get a COVID-19 [vaccination] shot at a doctor’s office,” said Dr. Geeta Nayyar, chief medical officer at Salesforce. “The consumer behavior will change.”

According to Nayyar, traditional providers won’t be able to compete with the convenience and scale retail outlets offer consumers. However, for more complex interactions traditional providers can still offer value and continuity. Weinstein said traditional providers would care for customers that “other people don’t want.” The most lucrative customers, he said, will be fiercely competed for among retail and tech outlets.

“Look at the deals,” Weinstein said. “[Traditional providers] are going to be left with what other people don’t want.”

Amazon recently acquired One Medical, has reported interest in Signify, and invested in the expansion of Amazon Care. Weinstein said Microsoft is different from Amazon. Rather than acquiring or building business lines to compete with traditional providers, the company is pitching itself as a partner. Microsoft recently announced a partnership with the University of Pittsburgh Medical Center focused on data optimization.

It won’t just be big tech and retail competing in this space. Multiple experts said the lines between payers and providers would continue to be blurred as digital health proliferates.

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3. The market continues to deliver solutions, but are there too many?  

Almost everyone agreed the boom of new digital health companies has come to an end. Following record-breaking investment in 2019 and 2020, funding this year has slowed. While the market has spun numerous solutions, it is likely saturated, experts say.  

“I think we're going to continue to see the use of digital tools to help enable healthcare delivery and patient engagement,” said Sheri Dodd, general manager at Medtronic Care Management Services. “This is going to continue to evolve, it's going to become more individualized for patients.” 

Not all the newly formed companies have strong leadership teams and sound business plans, experts said. As a result, there will likely be a slowing of new investment and an increase in merger and acquisition activity, especially as broader macroeconomic trends continue to inject uncertainty into the market. 

4. AI is here to stay. 

Multiple experts said younger clinicians entering the field have quickly adopted and largely embraced AI-based platforms. Those platforms range from administrative to clinical decision support. 

“We realized we could do a lot of things in the home, but the next step is what is the sophistication of that,” Nayyar said. “Figuring what patients, what specialties belong in the home.” 

Experts said digital health brings better access to providers. However, without building community trust—among both patients and providers—the benefits that technology advancements yield will be scarce. This is especially true in rural health, experts say.  

5. Regulatory changes could happen by year’s end.  

Sen. John Thune (R-S.D.) said he expected some movement on telehealth legislation, but not until the end of the year. Thune predicted the Senate could pass language solidifying reimbursement flexibility in an end-of-the-year omnibus bill, but likely not before. 

A bill passed 416-12 last month in the House of Representatives. That legislation, introduced by Reps. Liz Cheney (R-Wyo.) and Debbie Dingell (D-Mich.), would extend Medicare telehealth flexibilities established during the COVID-19 pandemic. The bill was endorsed by healthcare trade groups including the American Medical Association and the Connected Health Initiative. 

Interstate licensure will be harder to legislate. While some states have adopted regional agreements, the regulatory environment remains a patchwork. Thune, however, resisted supporting a federal fix. 

“My hope would be that we can solve that issue without having to have a federal government solution," he said. "I think there are good, organic solutions out there that are cropping up to deal with the licensure issue, but that is one challenge we’ll have to look at when we start looking at a permanent extension.” 

This story first appeared in Digital Health Business & Technology.