Teledermatology for the many, not the few: Tackling the racial health divide in a digital world

Abstract

evidence-based policy for a more egalitarian teledermatology service. This is illustrated in Table 1.Through ensuring equitable accessibility with a diverse set of policy, including an intersectional curriculum, the frontier of teledermatology may provide for the many, not just the few.

Virtual Consultation in Dermatology: Access Inequalities According to Socioeconomic Characteristics and the Place of Residence

“…On the contrary, the existence of a language barrier between a doctor and patient can be a bias [ 10 ], as it hinders the exchange of clinical information and the understanding of patient preferences. At the same time, a lower use of virtual consultation by some professionals can be explained by their concern about the increase in administrative work [ 27 ] derived from their management or their limited computer experience [ 28 ].…”

“…However, this is contrary to the initial objective of this tool, which is to facilitate care for dispersed and remote populations [ 30 , 31 ], reducing access inequalities [ 32 ] to healthcare due to the heterogeneous and centralized distribution of limited resources, both physical and human. As a consequence, patients who live in rural [ 8 ] and more deprived [ 10 ] areas are at higher risk of receiving lower quality, less effective, equitable and timely care, which can negatively influence their health outcomes. This is especially relevant in geographical areas such as the one in which this study was carried out, with high geographical dispersion and low population density.…”

“…The Multidimensional Readiness and Enablement Index for Health Technology (READHY), comprising the eHealth Literacy Questionnaire (eHLQ), Health Literacy Questionnaire (HLQ) and Health Education Impact Questionnaire (heiQ), can be used to assess patient skills, confidence and experience in using technology to manage their health [ 9 ]. Regarding professionals, having real-time access to interpretation services to overcome the language barrier [ 10 , 12 ], screening for skin lesions in patients with risk factors [ 12 ], increasing training in dermoscopy and digital image archiving and transmission [ 33 ] are useful strategies to improve the use of virtual interconsultation.…”

“…In the specific case of dermatology and virtual consultations, inequities in their use related to socioeconomic determinants have been described. Initially, it could be thought that patients from geographically isolated areas [ 10 ] and vulnerable groups could benefit the most from this type of resource. However, living in rural areas [ 8 ], not having the necessary technological means [ 11 ] or belonging to an ethnic minority [ 12 ] have been associated with a lower use of virtual consultations, especially if one is not fluent in the language of the country of residence [ 13 ].…”

The Digital Divide: A Qualitative Study of Technology Access in Rural Communities

“…The universal nature of the digital divide calls for customized interventions that consider the unique socioeconomic and cultural contexts of different rural populations. Innovations such as community internet centers, digital health solutions, and smart village projects have demonstrated potential in reducing the urban-rural digital gap and empowering rural communities through technology adoption (Halim & Noor, 2023;Hayre et al, 2021;Zerrer & Sept, 2020).…”