Since the start of the COVID-19 pandemic, telehealth has become an exponentially more popular choice for people seeking to receive care from a provider when nonessential care was put on hold. Even prior to the pandemic, though, telehealth had been steadily rising in popularity. Research suggests that between 2014 and 2018, the number of insurance claim lines for telehealth services increased about 1,400%, signaling a massive jump in utilization.
A key aspect of telehealth that has been heralded by proponents is the ability of telehealth to increase access to care and alleviate healthcare access inequalities, particularly for poorer and rural people.
But has this been the case? Has telehealth accomplished what we’d hoped it could? Researchers at Boston University’s Questrom School of Business, School of Medicine, and Boston Medical Center (BMC) suggest that the answer is a complicated one, labeling telehealth a “double-edged sword.”
A big part of telehealth’s uncertain role in alleviating healthcare inequities involves the “digital divide.” Specifically, researchers identify a type of “digital redlining” happening in telehealth, where telehealth, despite its barrier-breaking potential, inevitably becomes a barrier to accessing care that further perpetuates care inequity.
In a recent paper published in the Journal of General Internal Medicine, researchers outline their own experiences with patients as well as data about their patients’ experiences accessing healthcare. The data suggests two additional challenges to telehealth’s equalizing role: a patient’s digital literacy, or fluency, and a patient’s ability to advocate for themselves. Essentially, researchers concluded that telehealth on its own isn’t enough. Without robust infrastructure to support patients in the use of telehealth services, telehealth may just become another cog in the machine and further perpetuate access inequality.
In response to these challenges, researchers outline a framework for mitigating some of the downsides of telehealth in perpetuating healthcare inequities. Specifically, researchers suggest that policy makers can start investing in healthy literacy education, digital literacy education, and patient self advocacy.