The American Medical Association recently published a blog by NDIA Senior Fellow Amy Sheon called, The Digital Divide- Telehealth’s Achillie’s Heal. She shares with NDIA why she wrote it and what she hopes it accomplishes:

As you know, healthcare rapidly shifted from brick and mortar to telehealth due to COVID-19. The step is fundamentally important to the health and safety of everyone living in the U.S. Having patients determine the need for testing or hospitalization from home in three ways:

1)  Fewer people traveling to the doctor and sitting in waiting rooms minimizes exposure for the general public and reduces their own risk of contracting the infection 
2) Health care providers are exposed to fewer patients
3) Scarce PPE resources are saved.

The American Medical Association has done a great job supporting providers in making the complex transition to telehealth very rapidly, navigating the purchase of equipment, setting up secure connections, billing insurance, etc.

Bu absent from their material was as ingle word on helping patients to access this care, especially in light of the digital divide.

Health care is quick to offer what I call “Celleheath” to patients that only have audio connections due to lack of internet devices. This is second class healthcare compared with the much richer experience of two-way video connections that enable providers to see patients’ emotions, movement, their physical surroundings and to complete some parts of a physical exam. 

In the blog, I called on health care providers and systems to do the following: 

  • Reject the notion that the digital divide is immutable.
  • Don’t be willing to accept provision of second class care to patients who lack internet
  • Recognize that the digital divide is not a choice by patients not to use the internet but rather, reflects and reinforces of structural inequalities that are already associated with greater risk of contracting COVID-19 and poor health overall.
  • Just as schools have taken on the responsibility for connecting students so they can offer coursework online, health systems must do the same for patients.

I then called on health systems to:

  • Screen all patients to identify their need for devices, connectivity and digital skill training.
  • Refer those in need to local and national organizations (e.g. NDIA affiliates) to address these gaps.
  • Even better, provide these devices internet directly, or advocate for insurance reimbursement for these products and services.
  • Hire community health workers and digital navigators to provide technical support to patients who have difficulty using telehealth.

Finally, I urged them not to stop with telehealth that patients might use very episodically. Rather, they should encourage patients to use portals to the electronic health records where they can learn about their conditions, message their providers, request prescriptions, view lab test results, and make appointments.

After having chastised the only sector currently functioning in the economy, I sought to close on a positive note:

“If COVID-19 proves to have a silver lining, it will be because we equipped, connected, and trained the most economically and medically vulnerable members of our communities to use the internet to challenge and circumvent structural inequalities, and to manage their health. This will save lives and may even lead to more efficient, effective, and equitable care for years to come.”