Op-Ed: Pandemic highlights advances and barriers to patient-centered care in Puerto Rico
The pandemic has served to advance patient-centered care, while further exposing barriers to more technological innovations that could benefit patients.
One of the more obvious advances was the rapid growth of all telehealth solutions by both providers and patients, particularly during the stringent lockdown period that we experienced in 2020.
As we have slowly returned to a new kind of normalcy, telehealth services, like those offered through the online platform TeleConsultaMD, have remained at higher levels than were present prior to the pandemic and will continue to advance.
Another welcome development was the rapid adoption of applications for the delivery of prescription drugs and OTC to patients’ homes, like “Triple-S en casa,” as well as food delivery for those who qualify for those benefits.
Many patients, particularly younger ones, experienced the ease of use and the convenience of telemedicine for diagnosing and treating routine ailments, stomach problems, flu, and other infections and viruses. Increasingly, clinical labs are providing their results electronically. We are all excited by the possibilities that new technological developments offer for more effective patient care, from predictive analytics to artificial intelligence, the Internet of Medical Things to wearables that give our members the information they need to monitor their activity, hydration, body temperature, heartbeat, blood pressure and glucose levels.
Because many of the innovations in patient-centered care are based on technological applications, we find ourselves facing opportunities and barriers. All managed care organizations in Puerto Rico have proven to be highly innovative in using tech solutions to advance patient care. Yet, there are two main barriers that hinder our progress.
We are limited by inadequate premiums in the two key programs that dominate our health system, Medicaid and Medicare. Medicaid funding for Puerto Rico lacks stability and has traditionally been woefully underfunded compared to the states. Medicare Advantage benchmarks are about 40% less than the average in the US mainland.
Equally concerning is the digital divide present in our society. Although access to the Internet has been growing, those most in need often lack access to broadband. If we are to keep pace with most advances in patient-centered care, we will need to address the digital divide to achieve more equitable access, and that will require a public and private commitment to make it happen.
Moreover, Puerto Rico’s electrical grid and telecommunications infrastructure require major upgrading after Hurricane María. Our power and telecommunications systems remain fragile. They will require massive investment in the next few years to acquire robustness and to keep pace with rapid technological change in all fields, but particularly in health.
Those of us in the industry keep a close watch on the use of federal funds to rebuild our systems and on the Biden Administration’s proposal to invest in infrastructure.
The recent CIO & IT Leadership Virtual Conference 2021 held this month brought forth these reflections as I participated in the health industry panel with my colleagues, Juan José Díaz-Goitía from MCS, Juan Arill, from MMM, and our moderator Néstor Figueroa from Nagnoi. I hope our discussion will help address the barriers so we can make way for greater innovation in patient-centered care in Puerto Rico.