(Boston)—Health inequities among Black Indigenous People of Color, immigrant and low-income communities is driven largely by inadequate healthcare access. Telehealth offers an opportunity to increase healthcare access and reduce health inequities. However, according to researchers from Boston University Questrom School of Business, Boston University School of Medicine (BUSM), and Boston Medical Center (BMC), telehealth has unwittingly become a “double-edged sword,” whereby the technology with potential to reduce health inequities also holds the key to exacerbate structural inequities.
According to the researchers, a key component of these structural inequities is the digital divide, driven partly by “digital redlining.” Digital redlining is the modern day manifestation of redlining that perpetuates health inequities and structural racism by maintaining barriers to technological access, further perpetuating lack of healthcare access.
Based on their experience as well as data about their patients’ access to healthcare, virtual and otherwise, Mishuris and her colleagues theorize that two additional barriers to equitable telehealth exist: digital fluency, the ability to use digital tools efficiently and effectively; and the capacity for health advocacy, a patients’ ability to advocate for their own health needs.
“Without addressing these critical, less often discussed elements of telehealth implementation, it is our belief that telehealth will fall short of its promise and rather than mitigate health inequities, will perpetuate health inequities in the very communities that stand to benefit most from its implementation,” says co-author Katherine Gergen Barnett, MD, clinical associate professor of family medicine at BUSM and Vice Chair of Primary Care Innovation and Transformation at BMC.
In an effort to overcome the barriers of device and broadband access, digital fluency and health advocacy to mitigate current inequities in digital health engagement, the researchers propose a three-pronged approach of creating federal and state policies to democratize access to telehealth. “By establishing platform standards for accessing telehealth, and supporting societal and health system investments to increase health literacy, advocacy and technology fluency, we can begin to address the disparities in telehealth engagement and healthcare access,” says Mishuris.
These findings appear as a Perspective in the Journal of General Internal Medicine .
Funding was provided by the Boston University Center for Antiracist Research.
Journal of General Internal Medicine
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Telehealth’s Double-Edged Sword: Bridging or Perpetuating Health Inequities?
30-Mar-2022