Healthcare in Space, Part IV: Solving Healthcare Deserts

Introduction

In this series on healthcare in space, we’ve applied first principles thinking to address the unique challenges of establishing a healthcare system on Mars. By breaking down complex problems into fundamental elements, we've examined who the first settlers would be and their roles, the essential healthcare services and innovations required, and how to create a sustainable healthcare economy using innovative approaches like bartering and tokenization. This methodical approach ensures we develop effective, adaptable solutions tailored to the distinct environment of Mars.

But as much fun as it was to imagine life on Mars, for the majority of us Earthlings, we’re rooted firmly on this big blue planet we call home. And what good would this thought exercise be if we couldn’t use the solutions we uncovered to solve the healthcare desert problems at home?

To start, we’ll have to adapt some of the parameters we’ve set up on Mars to fit the realities on Earth:

Differences: Demographics and Service Mix

On Mars, we’ll likely be sending our best and brightest at their (relatively) physical peak, given the mission requirements of establishing a viable habitat for future explorers.

In contrast, the population in healthcare deserts on Earth tends to resemble those in rural America (of which 80% are medically underserved), in which they tend to be poorer and older, to live alone, and to be without health insurance.

We’ll have to focus healthcare services more towards chronic disease management, geriatric care, primary care, and preventive services to address a broader range of health needs effectively

Similarities between Mars and Earth

Fortunately, demographics and service mix are where the major differences end, and many of the concepts we previously explored on Mars can be applied back to Earth:

Healthcare Services Scarcities:

Problem: availability =\= access.

In healthcare deserts, resource scarcity is a significant challenge. Residents in these areas often have to travel long distances to see a doctor, with some reports indicating an average travel time of over 30 minutes to reach the nearest hospital.

While the number of healthcare workers in rural US (~13.1 per 1000) still satisfy the WHO’s guidelines for 2.5 medical staff (physician, nurse, specialist) per 1000 people is needed in order to maintain a healthy population, the low population density of rural areas (<500 per square mile vs >50,000 for urban areas) means that availability doesn’t equal access in healthcare deserts.

Solution: Leveraging Telemedicine and Mobile Healthcare

Telemedicine

Telemedicine can bridge the gap by providing remote consultations, reducing the need for travel, and offering timely medical advice. This involves deploying hardware such as tablets and diagnostic tools to support virtual visits, allowing patients to receive care from the comfort of their homes.

Mobile Healthcare Units:

Rural Hospitals are closing left and right, which unfortunately exposes the fact that the population challenges and reimbursement landscape does not allow for traditional hospital systems to survive economically in healthcare deserts.

In lieu of fixed locations and large campuses, we should design ways to bring healthcare to the patient to supplement telemedicine calls:

• Hospitals on Wheels: Mobile clinics can address on-demand healthcare needs, offering services like vaccinations, screenings, and minor treatments directly to communities, and make house calls when necessary.

• Modular Buildings: If we can leverage analytics to predict healthcare demands (ex: Asthma clinics during the fall and winter), we can deploy modular buildings that can be quickly set up to meet short-term demands, providing flexible healthcare infrastructure that can be expanded or relocated as needed.

Geographical Isolation:

Problem: Lack of supply

The general lack of healthcare services in healthcare deserts also means that healthcare-related supplies are hard to come by.

Pharmaceutical drugs shortage are unfortunately a persistent issue in the US, and rural areas, with their lower patient volume, are hit hardest by the shortage. Unless the shortage is completely replenish, rural areas will always be lower in supply priority compared to the larger urban hospitals.

Even basic medical equipment are in short supply, and was especially exposed during COVID.

Solution: Innovation in Drug Manufacturing and Medical Products

Drug Manufacturing:

The ability to manufacture drugs when in short supply is a critical step towards self-sufficiency. Innovations such as continuous manufacturing or 3D printing can be leveraged, and help rural healthcare providers not have to compete for resources against better funded health system.

Redesigning Medical Products:

While single use products may be safer, rural hospitals may not have the luxury of stockpiling lots of medical equipment. Redesigning them for multi-use with antimicrobial materials and designs enabling maximum sterilant penetration could prove useful to decrease the need to replenish products constantly.

Societal Isolation

Problem: Loneliness is a driver of health problems

Humans are inherently social creatures; we crave connection and interaction with others. This social need is vital for our mental health, as sustained loneliness can lead to adverse health outcomes. While the exact reason is complex, some studies show that rural folks feel more isolated despite having a larger social network.

Social isolation is associated with an increased risk of mental health issues such as depression and anxiety, and significantly increases a person’s risk of premature death from all causes.

Solution: Remote/In person Mental Health services

Mental health services are crucial for providing the emotional support needed to combat these negative effects. Leveraging telemedicine can make mental health support more accessible, allowing patients to connect with therapists and counselors remotely. Additionally, community healthcare workers play a critical role in offering on-the-ground support, fostering a sense of connection and providing essential services to those in isolated areas.

By integrating telemedicine and community healthcare workers, we can ensure that individuals in healthcare deserts receive the emotional and mental health support necessary for overall well-being. This approach helps mitigate the impacts of isolation and loneliness, promoting healthier and more connected communities.

Self-sustaining economy:

Rural areas are unfortunately less economically productive than urban areas, and often have trouble retaining talent to fill healthcare services and keeping hospitals open purely through financial means.

Much like on Mars, we’ll have to leverage alternative ways to represent and accumulate the value of healthcare in rural areas. We previously explored bartering as a way to exchange healthcare services for providing healthcare services. Like on Mars, bartering could be a good method for rural residents to trade non-healthcare goods for healthcare services, while digital tokenization can be a new medium of exchange without having to be completely dependent on current financial systems.

Conclusion:

While the challenges of healthcare deserts are numerous, reframing the thought process to Mars provided a clean slate for our thought experience, and fortunately, much of the solutions that worked on Mars seems to work on Earth as well. While the challenges of delivering care to rural areas are potentially much more complex that what we’ve described, this simplification provides aspiring entrepreneurs with a blueprint to start tackling healthcare deserts across America.

And that’s a wrap on this series on tackling healthcare deserts by rebuilding healthcare on Mars! Please subscribe to our newsletter if you haven’t, and share our newsletter with a friend. Stay tuned to our newsletter for more insights into healthcare innovation!

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