More Accessible Medicine? Telehealth’s Future Relies on Bridging the Digital Divide.

While it was formed as a response to the COVID-19 pandemic, telehealth is looking more and more likely to stick around. It provides a great opportunity to extend healthcare access to those who have never had it, but its potential cannot be realized until the right digital infrastructure is in place.

As we all know, a lot had to change after the outbreak of the COVID-19 in the name of safety. Eating at restaurants was out of the question, schools moved to a virtual format, and when one (albeit rarely!) left the house, a mask was a must. And while these consequences of the pandemic have fortunately all but subsided, one change that will happily be sticking around is the emergence of telehealth. As one would expect, not being able to visit the doctor or access health services was a rather large issue. Society had to innovate, using communications technology, be it phone calls, video calls, or even text messages, to access health care services. These practices, often labeled by the aforementioned term "telehealth" or similar terms like "telemedicine" or "e-medicine”, might not have perfectly replaced visiting one’s doctor in person, but they are a perfect option in addition to physical visits for a post-pandemic world due to one factor: accessibility.

Telehealth services are perfect for members of underserved communities who might not be able to access very necessary medical services. For patients who are elderly, are on the lower income spectrum, live in remote areas, or are in the midst of addiction recovery, physically getting to the doctor’s office was and continues to be a challenge, but telehealth is a solution. Expanded online services, during the pandemic and now, have led to care so affordable that many people in low-income communities have been able to access medical care for the first time. For patients with more specific needs, video visits are again a solution. Those who have never sought therapy in the past due to the stigma surrounding mental health treatments finally have an option that does not involve them driving and then sitting in a therapist’s office, and medical specialists are now accessible to patients outside of select major cities.

One great initiative that exemplifies the unique benefits of telehealth, for all communities, was launched by the state of Massachusetts this May in partnership with population health tech startup Color Health. Those who test positive for COVID-19 in the state can get free virtual consultations to determine whether they’re candidates for Paxlovid, the drug that’s been found to reduce severe infections and hospitalizations from the coronavirus by nearly 90 percent. The program will then send a prescription of the drug, free of charge, to a pharmacy near the patient or, if necessary, to the person’s home overnight. Since the treatment needs to be started within five days of symptoms, only telehealth makes it possible to receive the correct prescription for the drug while patients are still in quarantine.

There is, however, a catch to the benefits of telehealth: those who are most in need of this increased access to medical services are barred from it due to the digital divide. Many patients lack the physical devices needed to engage in a video visit, and even patients with capable devices often lack access to broadband internet or the digital literacy to use those devices. The New England Journal of Medicine quantifies this unfortunate reality, describing how one in four Americans would not be able to attend an online appointment if offered to them, and the current lack of infrastructure and digital literacy is thus preventing the long-term implementation of telehealth. Consequently, until we bridge the digital divide, we will not be able to realize the potential for these services to increase access to medical care for underserved communities.

In order to promote telehealth and accessible healthcare more broadly, initiatives targeting the digital divide are needed from all angles. I’ve already written about the work being done by the federal government, state governments, corporations, and organizations including but not limited to Philanthropy4Technology, but there is evidently a long road ahead. As part of a larger community dedicated to making the world a better place, we can take a few steps on the road to bridging the digital divide, and with the emergence of telehealth, equity in healthcare will naturally follow.