The American Medical Association this week released a report outlining key steps that organizations and policymakers should take in order to work toward equity in the telehealth landscape.
“Telehealth has the potential to be an important tool for addressing long-standing health inequities among historically marginalized and minoritized communities that have been impacted disproportionately by the COVID-19 pandemic,” said the organization in an issue brief.
“To realize telehealth’s full potential, the AMA believes that those developing and implementing telehealth solutions must prioritize partnerships with historically marginalized and minoritized populations to ensure that solutions are designed to be accessible and work well for all,” it continued.
WHY IT MATTERS
As telehealth continues to be a popular modality for care delivery, advocates, organizations and some lawmakers have stressed the importance of ensuring maximum access.
To that end, the AMA defined nine key proposals necessary to work toward telehealth equity:
- Broadband expansion, particularly for historically marginalized communities.
- Design functionality, content, user-interface and service-access best practices, in partnership with patients from marginalized groups.
- Intentional technology design geared toward those who have difficulty with technology access.
- Programs designed for measuring and strengthening digital literacy.
- Investment initiatives at hospitals, health plans and health systems aimed at widening access to care via telehealth, including devoting resources toward improving workforce diversity.
- Eligibility expansion for programs that help qualifying health entities buy telehealth equipment and services.
- Requirements for health plans to cover telehealth services on the same basis as in-person ones.
- Opposition of health plan efforts to use cost-sharing to encourage certain kinds of care over others.
- Equitable and fair payment for physicians.
“Far more emphasis needs to be placed on ensuring that telehealth solution functionality, content, user interface, and service access are designed with and for historically minoritized and marginalized communities,” said the association in its brief.
THE LARGER TREND
This past year, the AMA published a similar framework highlighting the value of virtual care, zooming in on value streams such as clinical outcomes, access to care and patient experience, along with health equity.
“The integration of new digital health solutions into digitally enabled care models offers the potential to address the quadruple aim … of high access, high quality, lower cost and high experience care,” said AMA researchers.
But different groups may not benefit equally. As researchers have noted, telemedicine in the age of COVID-19 grew the most in wealthy and metro areas, raising concerns about the replication of the digital divide in a virtual space.
ON THE RECORD
“Patient access to telehealth is inextricably linked to whether telehealth services provided by their physicians – the physicians with whom they have a relationship – are covered by their health plan,” said the AMA in its brief this week.
“As a result of the pandemic, adoption of telehealth has increased dramatically and is more likely to be available from an individual’s physician, essential to prioritizing continuity of care and the patient-physician relationship,” it continued.