With the implementation of the Affordable Care Act in 2010, hospitals and health insurance companies have been forced to develop innovative methods of working together to ensure profitability while at the same time providing quality health care to everyone under the variety of health plans offered. In addition, rural communities have found increased difficulty in ensuring immediate access to quality, specialized care.
The biggest issue is not everyone fits into neat categories where hospitals can provide that health care at the lowest possible cost. That is why contracting with health care insurance companies is important. But hospitals don't always ask the right questions in determining things such as population and the number of people who suffer from long-term or catastrophic diseases that should be managed over many years.
That is particularly true in West Texas, where the population is spread throughout numerous communities, not all of whom have access to the best health care, and primary care physicians. Getting medical care and supplies to people in the most of the rural areas, especially at a critical time of need, is crucial but can be difficult, especially in austere settings.
Researchers and students at Texas Tech University and Texas Tech University Health Sciences Center are looking into ways to expand hospital coverage to people in rural areas and in a cost-effective manner when contracting with certain health care insurance providers or in emergency medical situations.
“What we're trying to find out is, can higher education study the population distribution, catastrophic diseases and health care concerns specific to West Texas and provide that information to hospitals and tell them, when companies come to you for contract negotiations, you need to ask these specific questions,” said Ravi Vadapalli, a senior research associate in the High Performance Computing Center and site director for the National Science Foundation Cloud and Autonomic Computing Center at Texas Tech.
“If you have 1,000 patients, how many of them have catastrophic diseases like cancer or cardiovascular diseases? That will tell you how much income you will make or lose. That is the service model we are looking at.”
Drones and health care
One platform Vadapalli and his fellow researchers are analyzing is health information on the local, statewide and national levels and bringing them closer together so hospitals and health care providers can provide service to more people in a cost-efficient manner.
In addition, an interdisciplinary team of medical students and engineering students started a ‘Drone Club' at Texas Tech under faculty mentor Dr. Annette Sobel, and are developing new technical solutions to humanitarian and disaster response, and search and rescue operations using 3-D printing and advanced controllers. These students are partnering with Lubbock High School and the South Plains Chapter of Boy Scouts of America to develop a local chapter of invention scouts to develop innovative solutions to challenges of medical access using autonomous airborne platforms.
Over the years, health care has expanded from urban health systems, or hospitals and treatment facilities in larger cities, to rural health divisions and practices, where hospitals open branches in slightly smaller towns. Then came the advent of telemedicine, where telecommunication and information technology are used to provide healthcare from a distance, effectively reducing distance barriers to improve access to medical services.
In West Texas in particular, Vadapalli said, 90 percent of the population lives in rural areas. If someone in one of those rural areas developed an emergency health issue, how will they get the necessary care when they don't have time to be transported to a hospital, and a hospital is not going to open a branch in that community?
That could be where unmanned aerial vehicles (UAV), or drones, come into play. Vadapalli and other researchers are exploring the use of UAVs to deliver medicine to those rural areas that first responders would use to stabilize the patient so they can be transported to the hospital.
“What we are looking at is whether we can augment telemedicine and drones to supplement rural health care and make it equal to urban health systems,” Vadapalli said.
In theory, it is pretty simple. A person with an urgent medical condition contacts 911, but it could be several minutes before an ambulance arrives. That could mean the difference between life and death.
A UAV, however, could reach that person much more quickly with the medicine needed to treat or stabilize the patient. Through telemedicine, a doctor could instruct a first responder or someone else there how to administer the drug, and the patient could then be transported to a hospital in a larger city like Lubbock.
That also could save both the hospital and the health care provider, and in turn the patient, several thousand dollars.
“At the end of the day, if we can find a way to apply drones for that type of purpose, then we will save a substantial amount of money in terms of costs,” Vadapalli said. “Drones are not easy to work with and there are many federal mandates, so right now we're just going through the training.”
Learning to operate a UAV is a big step, but it's just one of several difficulties that must be overcome in this research.
Like any other use of drones, a central concern is ensuring the security of the drone and the medicine it could carry. Hackers commonly use technology such as GPS jammers to hijack drones, and if they're known to carry drugs such as stimulants or steroids, they could become an even more attractive target.
Vadapalli said fellow researchers are looking into putting transducers and other devices on UAVs in order to track them and develop security measures. One concept the researchers are looking into is partnering with local Boy Scouts, who would have a tracker attached to them and then spread out in different directions. A drone 100 feet in the air would then use transducers to track their movement, in effect simulating how fast a disease could spread and whether it can be monitored by the drone.
He added there are other areas where this technology could apply, and that the U.S. Department of Homeland Security has an interest overall in determining the consequences of landing drones in the wrong area as well as designing software resistant to GPS jamming or having someone possessing the software needed to capture a drone.
In terms of progress, however, this research is still in its initial stages.
“We're not there yet to even deploy a drone,” Vadapalli said. “We're talking to some companies for proof of concept, and if those alignments work out then we could probably go in six months to a year. There are a couple of students working on other concepts, and we're trying to send students to learning programs so they can get fully trained and be able to come back and test the drones and the software.”
There also are issues that must be resolved regarding payload. In theory, a drone used in this manner would not only have to carry the drugs or other medical supplies but also a camera for navigation purposes. That would mean either a larger-than-normal UAV or one that is heavily modified.
Vadapalli is encouraged, meanwhile, that their concept is being praised by other universities and research counterparts for its innovation and forward thinking.
“They're looking at us kind of in awe,” Vadapalli said. “We're ahead in terms of timing for doing things like this, but we're not ready to deploy them just yet.”