Access to good healthcare has always been one of the three pillars of ClickCare. We're driven by access, collaboration, and education. Ultimately, we believe that these are the three pillars of good medicine as well. 

It's been fascinating, though, to watch how good medicine starts to converge with what makes sense financially -- especially in the current climate of healthcare.

The more that medicine becomes linked to value and performance, the more crucial questions of access become for the sustainability and viability of hospital systems. If patients aren't able to access the care they need (including followup care, etc.), outcomes will not be what they should, which means higher costs in the long run. So it's more important than ever that we have a strong and sophisticated understanding of the dynamics around access.

We've found, though, that the general understanding of access to healthcare is lacking nuance and lacking evidence. For instance, when people think about telemedicine and telehealth, these technologies and practices are often thought of as bringing "medicine from the city to distant rural areas", thus improving access. That's why the common direct-to-patient model (a patient on a video call with a provider in another state) is frequently imagined as the primary vehicle for care. 

However, we've found that the obstacle to treatment -- the obstacle to access -- often isn't just a single consult with a provider: it's effective, timely, coordinated care by a team of providers. So we were interested to see that researchers at Princeton and Thomas Jefferson University argue that access in urban areas can be just as bad as access in rural areas. Ultimately, the issue isn't proximity to doctors -- it's whether or not you can access medicine and surgery in an effective and timely fashion. 

Access to quality healthcare derives from factors like these:

• The complexity of your disease.
  More complex situations multiply the providers who are trying to coordinate your care, and the longitudinal nature of the collaboration that has to take place.
• The complexity of your life situation.
  If you are homeless and have 7 children and just moved from a different country, then your access to care will be different than if you are a single man, with a job and a house, who has lived in the same town his whole life. If you are an Olympic athlete with cancer, the demands and constraints on your care are more than if you are a part-time computer programmer.
• Your economic and social status.
  Certainly, economic and social advantages tend to confer better medical care. Although an interesting note here is that it's not that the "the more money you have, the better your care." Sometimes economic and social status isn't as helpful as it might appear.
• Social support.
  Patients with supportive families and advocates will have more access to better care than those who struggle to get the support they need.
• Your geography. 
  As the article points out, there are "deserts" of care, both urban and rural. 

One of the reasons that we are so passionate about iClickCare is because we've seen patients get access to crucial medical care, in ways that would never have been possible otherwise.

We believe that the question of access is often a question of care coordination and medical collaboration. When providers are able to work together, with each other and with the patient, access to good care results. 

It's not an impossible goal -- and we all have the ability to impact it. We just have to use the tools we have.