The Rise ― and Demand — of Telehealth Equity
In early 2020, the world started to come to terms with a growing pandemic. Its impact on the health ecosystem was staggering.
An issue that arose was the dependence on the brick-and-mortar model of the healthcare system, which had not widely used technology solutions for virtual care delivery.
“One of the outcomes of COVID-19 was a greater awareness that we are overly reliant on a very old school way of delivering care. That wasn’t viable during COVID-19 and it’s not a sustainable, equitable delivery model,” said Sheri Dodd, vice president and general manager of Medtronic Care Management Services.
Digital health solutions, including remote patient monitoring, patient engagement apps, and telemedicine, helped expand healthcare access. Medicare visits, for example, conducted through telehealth increased from approximately 840,000 in 2019 to 52.7 million in 2020. It was a necessary pivot for quarantined patients to receive care and to minimize potential exposure to the virus for patients who still needed safe access to care. Digital health solutions also helped temper demands of a fragile healthcare system.
Telehealth became a viable solution for many. But one of the promises of telehealth solutions ― access to healthcare — seemed to be less effective in Black, Indigenous, and people of color, or BIPOC communities. The digital divide highlighted the need to rethink barriers and accelerators for telehealth and friendly adoption among patients. To that end, health technology leaders are adjusting their focus beyond sensors, software, and computational innovation. They are also considering issues of accessibility and what the patient prefers.
Last October, the National Committee for Quality Assurance (NCQA) convened a meeting on the future of virtual healthcare delivery in a post-pandemic world. The vision ultimately is to enable equitable, accessible, high-quality care. A diverse group of stakeholders were asked for recommendations to help realize the potential for telehealth — to drive well-coordinated, patient-centered, value-optimized care.
Dodd was among the thought leaders. She said, "if healthcare was empowering, holistic, and outcomes-driven — and emphasized the experience of the patient all the way through — digital health technologies would be designed very differently." That would require a shift within the U.S. healthcare system primarily to prioritize a patient-centered approach to care.
As it stands, when it comes to adopting digital health technologies, there are significant barriers among minoritized patients including: privacy concerns, lack of trust, and limited or no broadband access.
Health systems have not been set up to inclusively accommodate all patients which impacts BIPOC communities. But that has the potential to change with emerging digital and home-based technologies. When it comes to the evolution of healthcare technology and the expanding adoption of digital-based products, Dodd said, “we’re going to expand our readiness, which could mean partnering with telecommunications platforms in new ways and changing our perspective on the role it can and should play.” She added, “it truly is going to be an ecosystem that will enable and unlock the full power of digital technologies to help serve patients wherever they are and whatever type of situation they happen to be in.”
The inclusion of a more focused telehealth system will no doubt include access to affordable high-speed internet, healthcare systems, and community healthcare partnerships. It will also take the emergence of a “new” healthcare workforce that can support different patient populations as well as collaborations outside of the medical technology field.
When that happens there is huge opportunity to engineer solutions that are truly extraordinary.
There is incentive to address the gaps in care and expand access as demand for telehealth technology evolves. The NCQA panel determined telehealth technologies and related digital tools can be cost-effective for delivering both primary and specialty care. And they concluded that industries can and should embrace this solution, bearing in mind technology is a healthcare tool that must solve for many problems caused by social determinants of health.
In the end, prioritizing all patients regardless of race, region, or background would allow communities to experience and sustain the kind of quality care healthcare providers intend to give.