“Can you see my screen?” Addressing Racial and Ethnic Disparities in Telehealth

Abstract

Purpose of Review Telehealth is an innovative approach with great potential to bridge the healthcare delivery gap, especially for underserved communities. While minority populations represent a target audience that could benefit significantly from this modern solution, little of the existing literature speaks to its acceptability, accessibility, and overall effectiveness in underserved populations. Here, we review the various challenges and achievements of contemporary telehealth and explore its impact on care delivery as an alternative or adjunct to traditional healthcare delivery systems. Recent Findings Given the COVID-19 pandemic, there has been a rapid acceleration in telemedicine adoption. Recent studies of telemedicine utilization during the pandemic reveal stark disparities in telemedicine modality use based on race, socioeconomic status, geography, and age. Summary While telehealth has great potential to overcome healthcare obstacles, the digital divide stands as a challenge to equitable telehealth and telemedicine adoption. Achieving health equity in telehealth will require the mobilization of resources, financial incentives, and political will among hospital systems, insurance companies, and government officials.

Why do we fall short in reaching equity in telerheumatology?

“…The lack of a structural platform for Telehealth is consistent with the definition of physical access [13] (physical availability of the internet and electricity [14] ) and the ability to maintain good-quality services over time [15] which is influenced by socioeconomic status and social network [16] . Moreover, resistance to change among patients and physicians has been also identified as a barrier.…”

The digital rainbow: Digital determinants of health inequities

“…For example, telemedicine applications to service remote and rural areas with specialist medical care and knowledge can indeed improve access for otherwise disadvantaged populations—in particular in emergency situations such as the SARS-CoV-2 pandemic. 9 , 23 As discussed above, socioeconomic barriers to access telemedicine services—either through lack of individual resources such as internet provider contracts with sufficient bandwidth and data volume 24 or through the lack of effective technological and personnel infrastructure 25 are likely to exacerbate existing inequities in access to medical services. Increasingly, health insurances employ digital assistants in customer contact, for example in directing customers to appropriate healthcare providers, and it is not entirely unlikely that the lower costs incurred through such digital assistants could lead to their increasing implementation in lower cost tariffs.…”

Virtual Access to Subspecialty Care

“…Multiple observational studies have shown that patients that are non-White, older, in lower socioeconomic groups, non-English speaking, or with lower education had lower utilization of telehealth and access to cardiac devices to facilitate virtual visits. 19 , 20 , 21 …”