Telehealth equity key to addressing digital gaps

Alexandra Hunter, virtual care consultant at Henry Ford Health, speaks Tuesday at the HIMSS24 annual conference in Orlando.

Photo: Jeff Lagasse/Healthcare Finance News

ORLANDO – Telehealth technology has advanced rapidly over the past few years, and while it's both popular and promising, it has also shined a light on the contrast between patient populations with and without adequate access and digital health literacy, the latter of which are less likely to engage in this type of medical care.

That's where a digital equity strategy comes in. Digital equity in this instance is defined as the idea that everyone should have the information technology capacity needed for full participation in society, democracy and the economy.

Alexandra Hunter, virtual care consultant at Henry Ford Health, in her session "Addressing the Gaps in Digital and Telehealth Equity Through Strategy" at the HIMSS24 conference here Tuesday, said there's a strong connection between the populations that experience barriers in access to broadband and are digitally illiterate, and those who have a higher prevalence of, and premature mortality from, chronic health conditions.

Examples of an equitable approach to telehealth, she said, may include a permanent expansion of telehealth reimbursement, discounted broadband (or broadband on a sliding pricing scale), and providing internet in public spaces or affordable housing developments. Technical support in clinics with lower telehealth adoption is another component of the methodology, as is increasing access to devices such as in school laptop programs and public computer centers and mobile computer labs.

Health apps could be made more equitable, said Hunter, because most are designed with high-frequency digital users in mind.

"Patient-facing health apps have poor usability for populations with poor health literacy," she said. "When we're building these things, are we thinking about these populations at the beginning of the process, or at the end?"

When developing a telehealth equity strategy, it's important first to identify potential disparities in access, whether it be socioeconomic disadvantages that prevent internet access, age, race/ethnicity or other factors that can prevent people from utilizing the technology. 

To curb digital illiteracy, Hunter and her team are developing education and training to teach patients the digital skills to conduct video visits and inform patients about newly free or discounted internet service in their area.

Some barriers, said Hunter, exist within the healthcare system itself, but can be curbed through practices such as ensuring language interpreter access, offering video visits to every patient when clinically appropriate and offering telephone visits if they're unable to mitigate barriers to video access.

To sustain this progress, Hunter advocated for a permanent expansion of free or low-cost broadband and providing funding for telehealth expansion in less resourced areas.

There's no shortage of populations that could stand to benefit from increased equity, she said. Those with hearing and vision impairments, non-verbal patients, non-English speakers, older patients and those who require technical support all need consideration.

Of course, any kind of equity initiative requires funding. According to Hunter, those designing grant applications should consider brainstorming the approach, and collect as much data and information as possible on the local population and its specific needs.

"Programmatic activity can really address the gaps in digital and telehealth equity," said Hunter.
 

Jeff Lagasse is editor of Healthcare Finance News.
Email: jlagasse@himss.org
Healthcare Finance News is a HIMSS Media publication.