Digital Health Equity and COVID-19: The Innovation Curve Cannot Reinforce the Social Gradient of Health

Crawford, Allison; Serhal, Eva

doi:10.2196/19361

Cited by 434 publications

(455 citation statements)

References 8 publications

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“…37 The rapid transformation of healthcare delivery increases access for many through telemedicine alternatives and will hopefully be a long-lasting consequence of the COVID-19 pandemic, 7 but access for some already disenfranchised groups may be further reduced unless we are particularly conscious of this risk. 38 Interruption of medical care, exercise, and social activities were also associated with exacerbation of PD symptoms. The effect was even greater among those asked to socially isolate or quarantine.…”

Section: Discussionmentioning

confidence: 99%

The Effect of the COVID-19 Pandemic on People with Parkinson’s Disease

Brown

Chahine

Goldman

et al. 2020

Preprint

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Objective: To rapidly identify areas of need and improve care in people with Parkinson's disease (PwPD) affected by the COVID-19 pandemic, we deployed a survey focusing on the presentation and complications of COVID-19 infection and the effect of the COVID-19 pandemic among those not infected. Methods: Individuals with and without PD participating in the online study Fox Insight (FI) were invited to complete an online survey between April 23-May 23, 2020. Among people reporting COVID-19 diagnosis, we compared the frequency of symptoms and poor outcomes in people with and without PD. Among people not reporting COVID-19, we assessed the effects of the pandemic on access to medical care and other services, and in PwPD, its effects on PD symptoms. Results: Among 5,429 PwPD and 1,452 without PD, 77 reported a COVID-19 diagnosis (51 PwPD, 26 without PD). Complications were more frequent in people with longer PD duration. PwPD and COVID-19 experienced new or worsening motor (63%) and nonmotor (75%) PD symptoms. PwPD not diagnosed with COVID-19 reported disrupted medical care (64%), exercise (21%), and social activities (57%), and worsened PD motor (43%) and non-motor (52%) symptoms. Disruptions were more common for PwPD living alone, and for those with lower income and non-white race. Conclusions: The COVID-19 pandemic is associated with wide-ranging effects on people with PD, and certain groups may be at particular risk. FI provides a rapid, patient-centered means to assess these effects and identify needs that can be used to improve the health of PwPD.

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Section: Discussionmentioning

confidence: 99%

The Effect of the COVID-19 Pandemic on People with Parkinson’s Disease

Brown

Chahine

Goldman

et al. 2020

Preprint

View full text Add to dashboard Cite

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“…After the advent of the COVID-19 pandemic, our team has also committed to taking a digital health equity perspective, working toward more equitable access to telehealth, while also recognizing that larger structural factors may impact access to technology and/or influence comfort with accessing care using technology [ 41 ]. In the future, we will ensure that the survey addresses equity, an important HSO identified by the Institute of Medicine [ 23 ].…”

Section: Discussionmentioning

confidence: 99%

Client Satisfaction and Experience With Telepsychiatry: Development and Validation of a Survey Using Clinical Quality Domains

Serhal¹,

Kirvan²,

Sanches³

et al. 2020

J Med Internet Res

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Background Telepsychiatry is an increasingly used model of mental health care that connects patients with psychiatrists at a distance via videoconference. Telepsychiatry is an effective clinical intervention that improves access to quality care in regions with limited resources or in clinical situations where in-person care is unavailable. Objective This study aims to develop a validated survey tool to measure patient experience and satisfaction with telepsychiatry based on the quality of care domains. This study also seeks to understand which health service outcomes were most strongly correlated with overall satisfaction in the context of telepsychiatry. Methods The survey created in this study was developed and validated with a panel of subject matter and process experts and was piloted with 274 patients who received clinical consultations through the TeleMental Health Program at the Centre for Addiction and Mental Health. Factor analysis was used to determine correlations between questions and quality of care domains and was also used to assess model fit. Results The study provides a validated survey to measure patient satisfaction and experience with telepsychiatry across 4 domains: access and timeliness, appropriateness, effectiveness, and safety. Both safety and access and timeliness were found to be statistically significant predictors of satisfaction in our sample. Conclusions By situating patient satisfaction and experience within this framework, the survey facilitates patient data collection and interpretation through a clinical quality lens.

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“…The COVID-19 pandemic emphasizes issues of inequity. Health professionals need to advocate for equalizing access and adopting a "digital health equity framework" [70].…”

Section: Technology To Facilitate Coordinated Multidisciplinary Carementioning

confidence: 99%

Coping, fostering resilience, and driving care innovation for autistic people and their families during the COVID-19 pandemic and beyond

et al. 2020

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The new coronavirus disease (COVID-19) pandemic is changing how society operates. Environmental changes, disrupted routines, and reduced access to services and social networks will have a unique impact on autistic individuals and their families and will contribute to significant deterioration in some. Access to support is crucial to address vulnerability factors, guide adjustments in home environments, and apply mitigation strategies to improve coping. The current crisis highlights that our regular care systems are not sufficient to meet the needs of the autism communities. In many parts of the world, people have shifted to online school and increased use of remote delivery of healthcare and autism supports. Access to these services needs to be increased to mitigate the negative impact of COVID-19 and future epidemics/pandemics. The rapid expansion in the use of telehealth platforms can have a positive impact on both care and research. It can help to address key priorities for the autism communities including long waitlists for assessment and care, access to services in remote locations, and restricted hours of service. However, system-level changes are urgently needed to ensure equitable access and flexible care models, especially for families and individuals who are socioeconomically disadvantaged. COVID-19 mandates the use of technology to support a broader range of care options and better meet the diverse needs of autistic people and their families. It behooves us to use this crisis as an opportunity to foster resilience not only for a given individual or their family, but also the system: to drive enduring and autism-friendly changes in healthcare, social systems, and the broader socio-ecological contexts.

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Digital Health Equity and COVID-19: The Innovation Curve Cannot Reinforce the Social Gradient of Health

Cited by 434 publications

References 8 publications

The Effect of the COVID-19 Pandemic on People with Parkinson’s Disease

The Effect of the COVID-19 Pandemic on People with Parkinson’s Disease

Client Satisfaction and Experience With Telepsychiatry: Development and Validation of a Survey Using Clinical Quality Domains

Coping, fostering resilience, and driving care innovation for autistic people and their families during the COVID-19 pandemic and beyond

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