Healthcare in the United States is not the same for everyone. Groups like racial and ethnic minorities, low-income people, people living in rural areas, and older adults often face many problems getting care. Telehealth means getting health services remotely using technology. It can help reduce some of these problems. Still, telehealth also brings new challenges. Medical administrators, healthcare owners, and IT managers need to manage these carefully.
This article explains the main challenges in making telehealth fair for all groups and offers simple solutions. It also talks about how artificial intelligence (AI) and automation can make telehealth work better and reach more people fairly.
Telehealth lets patients see healthcare providers by video or phone. This means they don’t have to travel far. This is useful for groups who cannot travel easily because of no transport, disabilities, or living far from clinics. For example, rural areas in the U.S. have fewer doctors—68 doctors per 100,000 people compared to 80 in cities. Telehealth helps by removing long-distance travel.
During the COVID-19 pandemic, telehealth grew fast. It helped keep care going while reducing the risk of infection. Telehealth showed promise in services for mothers and children, helping reduce some health gaps. Research by Mehrete Girmay at Southern Illinois University found telehealth helped pregnant women who often have a higher risk of death, especially non-Hispanic Black women. Their death rate was 69.9 per 100,000 live births, which is more than twice that of non-Hispanic White women.
Telehealth also saves travel time and money. This helps low-income families and those with chronic illness. Studies found many patients were happy with telehealth programs for mothers and children because of these benefits.
However, many people in marginalized groups face big barriers to using telehealth:
For telehealth to help everyone, the digital divide must be fixed. Rural areas often do not have broadband internet or find it too expensive. The Broadband Equity, Access, and Deployment Program started in 2021 to improve internet in these places. It helps hospitals keep patients nearby by offering specialty visits remotely. This reduces the need to send patients to far cities which can take time and money.
Urban areas also have problems. Studies in Baltimore show that people with the lowest incomes and education, and older adults from Black, Asian, and Latino groups, use telehealth less, especially video visits. This shows that audio-only telehealth should be covered by insurance so more people have access.
Federal groups work on telehealth equity as well. The Association of American Medical Colleges (AAMC) runs Project CORE, helping doctors and specialists communicate better, serving 4 million patients across more than 55 health systems. AAMC also gives awards to programs that work to improve care access for underserved groups.
The Biden Administration has made health equity a priority with new orders and policies focusing on expanding health coverage and social programs. For example, expanding the Child Tax Credit helped reduce child poverty and improved health for Black and Hispanic children. But issues like poverty, housing, and systemic racism still block progress.
Healthcare leaders can try these ways to make telehealth better and fairer:
AI (artificial intelligence) and automation help run telehealth better, especially in offices for tasks like appointment scheduling and patient communication. These tools improve patient experience and help clinics work well, which is important for places with limited staff.
For example, AI phone systems can answer patient calls anytime for booking visits, reminding appointments, and simple health questions without needing staff to answer. This helps clinics with few workers.
Main uses of AI and automation include:
It is important to make sure AI tools are fair to everyone. Using diverse data and checking for bias during development is needed.
Telehealth alone cannot fix all problems. Issues like housing problems, poverty, education, and racism affect health. Health services and social supports need to work together.
Healthcare groups can:
Healthcare leaders and IT managers play a key role in making telehealth fair:
Telehealth can help reduce health differences and improve access for marginalized groups in the United States. But to make it work well, digital, social, and system problems must be solved. By improving internet access, staff training, accessible technology, community cooperation, and using AI tools carefully, healthcare leaders can reach more patients fairly. These efforts can lead to better health for individuals and help make healthcare fairer for all.
Telehealth refers to the use of technology to deliver healthcare services at a distance, enabling providers to care for patients remotely.
During the pandemic, telehealth adoption surged as health systems sought ways to provide care while protecting the safety of both patients and healthcare providers.
Telehealth has the potential to enhance medical education by integrating technology into training, thereby improving access to resources and real-world clinical experiences.
The AAMC supports telehealth implementation in academic medicine through initiatives, resources, and training aimed at improving access and quality of care.
Project CORE is an initiative that implements eConsults for better communication between primary care providers and specialists, improving patient access to needed specialty care.
The AAMC has developed functional requirements for telehealth technologies to ensure they promote patient-centered, equitable care and address barriers to access.
Telehealth can improve health equity by expanding access to care for marginalized communities, but it also necessitates addressing existing barriers to digital inclusion.
Effective strategies include understanding motivations for telehealth use, focusing on integration into clinical operations, and evaluating clinical performance outcomes post-adoption.
Telehealth competencies are critical skills and knowledge areas defined by the AAMC to guide medical education and training for effective telehealth practice.
Academic health centers can leverage telehealth by integrating it into their broader operational strategies, focusing on quality improvement, workforce training, and research initiatives.
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