By Theresa Ahearn
COVID-19 has influenced the way we use technology, from virtual learning to remote work, reliance on virtual interactions and the amplification of digital tools. An essential use of technology that emerged during the crisis was telemedicine. The use of telemedicine was understandably accelerated during the COVID-19 pandemic because it presents a safe alternative for patients to access healthcare. Though virtual healthcare has been around for some time, it was the exception, not the norm. Today, there is a necessity among healthcare workers, policymakers, and insurance providers to adopt new technologies that enable the assessment and treatment of patients virtually. (Clipper, 2020) However, as the popularity of telehealth grows, valid concerns remain as to how the digital age could magnify the pre-existing gaps in healthcare.
Throughout the United States, health inequalities among minority groups have been well reported, largely due to pre-existing medical or chronic conditions, particularly those affecting the elderly. The lack of access to specialized healthcare services is a growing concern in rural and underserved geographic locations as well. As highlighted in a previous DOCS blog, Serving Rural Dental Patients in the age of COVID-19, access to dentistry in rural or underserved areas continues to occur across America. Though recent studies have shown that the majority of dental practices are now embracing using teledentistry. Telehealth is positioned to eradicate a significant number of the boundaries to medical care access, including geological area, diversity of services, and cost. Dental practices that deploy virtual services are paving a new frontier for dental medicine, enabling patients to be virtually examined, and treated without the need to step foot in a facility. (Keough et al., 2020) The increased use and acceptance of telemedicine in specialized areas including dental could arguably help bridge the gap of access to underserved populations however, the disparities in healthcare are more than just access.
Legitimate concerns remain about how technological advances could cause unintended challenges for under-resourced populations. For example, broadband and digital devices are necessary for patients to be able to use telehealth or teledentistry services. However, almost 21 million people in the United States do not have broadband access. (Anderson, 2020) Along with broadband, digital devices such as a laptop or smartphone are fundamental for patients to be able to engage with their healthcare providers remotely. Though 85% of the US population owns a smartphone, there are existing gaps in socioeconomic status and literacy challenges that continue to create barriers. (Jaffe, 2020)
Obstacles to Overcome
Another barrier influencing the digital divide in healthcare is the marketing of healthcare technology. Marketing innovation in health care technology is often geared toward middle- and high-income customers who have health coverage through an employer. Marketing to consumers with Medicaid for example is less common. (Lee et al., 2020) Statistics on Medicaid enrollment in the United States suggest that more than 1 in 5 Americans use Medicaid. Much of the population who depend on Medicaid coverage are those in vulnerable populations, including the elderly, disabled, and low-income. During COVID-19 the federal government took action to make telemedicine more widely available, including expanding access to rural areas and increasing the types of services that can be provided via audio-only telephones (Musumeci and Dolan, 2021). Though these actions are a step in the right direction, it remains unclear if policy changes will remain in place post-pandemic. Prior to COVID-19, federal reimbursement policies for Medicare imposed limitations on how and where telehealth services could be covered, creating barriers based on geographic location and services needed. To fully embrace telehealth existing states and federal policies will need to be adjusted to remove barriers that hinder reimbursement, access, and services.
As the shift to digital health care continues, the urgency to improve the digital divide in healthcare will continue to gain publicity. Creating a more equitable digital health landscape will require combined efforts between insurance companies, healthcare institutions, policymakers, providers and patients. Providers could start to improve the gap by working together with their stakeholders. For example, surveying their patients about technology access or implementing improvements to digital tools based on user feedback or challenges could go a long way to improve the digital divide. Without a combined effort, healthcare disparities will only widen.
Author: Theresa Ahearn is a freelance writer, currently residing in Oak Ridge, Tennessee. She received her Bachelor of Arts from the New York Institute of Technology and Master of Science from Central Connecticut State University. When not writing she can be found fishing or traveling someplace new.