The Five A's of Access for TechQuity

Abstract

The COVID-19 pandemic caused a rapid and significant shift from in-person health care to care delivered virtually, highlighting the impact of disparities in access to technology. Penchansky and Thomas conceptualized the idea of access to health care as comprising five dimensions, known as the Five A's of access: affordability, availability, accessibility, accommodation, and acceptability. Considering these dimensions of access allowed health care systems to dissect barriers to access to better identify ways to overcome them. In the current health care landscape, we must consider technology access. For example, patients without Internet service, appropriate devices, and digital literacy skills experience greater challenges in accessing care via telehealth. To ensure equitable technology access, or techQuity, health care systems must identify data to monitor the Five A's of technology access. We re-envision the Five A's of access as they relate to access to technology for telehealth and present a framework for evaluating a health care system's techQuity.

Prioritization of Features for Mobile Apps for Families in a Federal Nutrition Program for Low-Income Women, Infants, and Children: User-Centered Design Approach

“…As our current and ever-changing health care landscape becomes increasingly dependent on technology, the five A's of access (affordability, availability, accessibility, accommodation, and acceptability) must be considered when implementing these systems to ensure equitable care for those who need it the most [49].…”

Sign of the times: Community engagement to refine a cardiovascular mHealth intervention through a virtual focus group series during the COVID-19 Pandemic

“…The FAITH! App gained further acceptability 47 within the community as it was designed for community members by community members and thus enhanced recruitment of AAs from these communities for the RCT. These are important steps toward moving the needle toward digital health equity for AAs.…”

Necessity as the Catalyst of Change: Exploring Client and Provider Perspectives of Accelerated Implementation of Telehealth by a Regional Australian Community Service Organisation during COVID-19 Restrictions

“…However, the rapid digitalisation catalysed by COVID-19 has also “highlighted the broad implications of the digital divide” [ 48 ] (p. 291). Disparities in digital literacy, access to reliable internet, and ownership of devices or hardware exclude some people from accessing telehealth services [ 48 ]. This is of particular concern for regional and rural residents, who tend to fall into lower-income brackets [ 17 ] and thus may experience difficulties affording the technology or data needed to support online telehealth sessions [ 16 , 49 ].…”

“…The benefits of this for vulnerable groups, such as those living rurally, are well documented (11)(12). However, the rapid digitalisation catalysed by COVID-19 has also "highlighted the broad implications of the digital divide" [48] (p. 291). Disparities in digital literacy, access to reliable internet, and ownership of devices or hardware exclude some people from accessing telehealth services [48].…”