There is no doubt that the rapid deregulation of telemedicine in the United States during the pandemic has allowed millions of patients to access care during a period in which they could not be seen in person. It has been widely accepted and working well in many cases. People view the fast expansion of telehealth as an unexpected “benefit” of the COVID-10 pandemic. However, many providers state that their current telehealth technology has restrictions and leave their most vulnerable patients behind. We found that the following challenges occur in most of the major healthcare systems:
Underserved population. Patients with limited English proficiency, immigrants and refugees, essential workers and patients for whom social determinants such as lack of stable income, housing and food has limited or no access to telehealth service. Language barriers are difficult to overcome during remote visits. It has proven very difficult to implement on-camera interpreter services even in prominent health-care systems. Although the quick development of digital technology makes telehealth service more versatile, it leaves the patients with limited English proficiency behind.
Video adds a great deal to patient care but is not offered by most of telehealth enabled organizations. Many physicians agree that it is important to see a patient’s facial expressions, their self-care, their home environment, and the way they move around. Even though over 81% of people in the US own a smartphone and nearly three quarters of US adults own computers, there are some complications that can arise:
Availability. Some healthcare providers do not integrate a secure webcam system yet
Identification. Cumbersome sign-up processes scared people away. The video profile creation process seem to be the equivalent of a credit check
Technical Issues. Video invitations sent via email are inconsistent and sometimes involve technical challenges
Privacy and Compliance. There is no control to ensure the appropriate privacy and compliance on a remote communication platform. While a traditional doctor visit usually is offered in a closed-door setting between the patient and physician only, remote care cannot filter unexpected personnel involved in the conversation even they are not shown in the camera or speaking on the side. Unexpected participants might seem harmless but have major implications for disclosure around sensitive matters.
It is important to force healthcare systems to make the substantial investment necessary to ensure telehealth equality. The foundation of digital health needs to be reinforced. Developing a customized, robust, and secure system is the solution.
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Source: Mobile Fact Sheet https://www.pewresearch.org/internet/fact-sheet/mobile/
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