Improving telehealth means addressing inequality in healthcare

March 10, 2021
Dessiree Paoli

Dessiree Paoli is a senior solution manager at Interlace Health, a company that transforms workflows by providing clinicians and patients with digital healthcare solutions. She has more than 18 years of experience in driving strategic marketing initiatives, leading teams, and developing integrated campaigns, and she has worked in healthcare for more than 12 years.

As telehealth expands, it’s imperative that the industry address existing discrimination and inequality in healthcare instead of contributing to the problem.

Silver linings during the pandemic have been rare, but one bright spot is clear: The rapid emergence of telehealth has given patients access to healthcare professionals without putting either party at increased risk of contracting the coronavirus. For example, Stanford Medicine went from seeing about 2 percent of patients virtually to handling 80 percent of its patients via digital visits. Although these numbers will undoubtedly decline as COVID-19 cases drop and vaccine distribution accelerates, telehealth is here to stay.

While telehealth does make it easier for patients to see doctors in many cases, research has cited disparities in access, particularly for marginalized groups that might not have internet access. Where we live, local policies and regulations, and even barriers to providers can all affect our ability to access telehealth fairly and equitably.

In developed urban areas, 97 percent of people have high-speed internet access. But when considering health inequalities in rural and remote areas, that proportion falls to 65 percent. Access is even less common among some groups: People who have disabilities are 14 percent less likely to have quality broadband access; Black patients suffering from certain chronic conditions were 51 percent less likely to have internet access than their white counterparts; and Hispanic patients were 42 percent less likely.

Moreover, many communities don’t trust healthcare institutions because of a history of discrimination. Patients in minority communities are more likely to feel like they can’t openly communicate with their doctors and nurses and fear poor quality of care. They also face the legitimate threat of bias in telehealth algorithms; healthcare technologies don’t fully account for the complexity of variables involved in each case.

As telehealth continues to expand and become a critical tool for delivering superior healthcare outcomes, it’s imperative that the industry address existing discrimination and inequality in healthcare instead of contributing to the problem. How? It all starts with awareness. To lay the foundation to address these problems, they must spend time working to understand where these disparities exist and how they might be barring people from telemedicine.

Once industry leaders gain some level of awareness, there are concrete opportunities to make changes. Providers can, for example, offer telehealth visits over the phone for anyone who lacks internet access. There can also be an investment in telecommunications infrastructure in places where it’s lacking or simply doesn’t exist.

While we can’t solve all inequalities in healthcare access overnight, there are three steps providers can take now to begin improving telehealth processes:

1. Digitize paper processes.

Even though most healthcare providers have been using electronic health records (EHRs) for almost a decade, many still rely on paper forms to onboard new patients, acquire consent, and more. Eliminating cumbersome paperwork can save staff time and eliminate the costs associated with printing, scanning, labeling, and more. Digital records also reduce the time administrators spend trying to decipher illegible handwriting from physicians and patients alike. Integrating electronic solutions in other parts of healthcare gives providers more time to provide quality virtual care.

2. Work toward better care continuity.

When patients use on-demand telehealth services, they may not have any continuity in healthcare providers. Primary care providers, for example, might not have full access to information about telehealth visits their patients have done with other providers and healthcare professionals, leaving them with an incomplete patient history. This knowledge creates an opportunity to improve telehealth, illuminating the need to maintain accessible and detailed patient records to ensure the best care possible for all who receive it — no matter where that care happens or which providers are involved.

3. Make telehealth platforms more inclusive.

As healthcare organizations and professionals work to make telehealth access genuinely equitable for all, they must also work to make it an equitable service. The technology should be accessible and customizable to meet the needs of all users. For example, these platforms should not be limited to English — they should offer enhanced options and translation capabilities for other languages. For patients struggling with a language barrier, the technology should find ways to address those challenges and help provide care.

Virtual visits have become a staple of healthcare, but the work isn’t finished. Improving telehealth is an ongoing mission that can improve outcomes for everyone — all while fighting discrimination and inequality in healthcare. There is critical work to be done tackling telehealth challenges, seizing incredible opportunities, and knocking down barriers to telehealth implementation disproportionately impacting already disadvantaged populations. It’s time to get started.

Dessiree Paoli is a senior solution manager at Interlace Health, a company that transforms workflows by providing clinicians and patients with digital healthcare solutions. She has more than 18 years of experience in driving strategic marketing initiatives, leading teams, and developing integrated campaigns, and she has worked in healthcare for more than 12 years.