Telehealth: Bridging or perpeatuating health inequities?

Date:
March 30, 2022
Source:
Boston University School of Medicine
Summary:
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,
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.



FULL STORY ========================================================================== 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.


========================================================================== "Using qualitative data and our own experiences as front line primary
care physicians we discovered that while digital access is necessary,
it is not sufficientin redressing disparate engagement with telehealth,"
says corresponding author Rebecca G. Mishuris, MD, MPH, MS, assistant
professor of medicine at BUSM, and primary care physician and Chief
Medical Information Officer of the BMC Health System.

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.

Collaborators include Jayakanth Srinivasan, PhD, research associate
professor at Boston University's Questrom School of Business; Charles
T. Williams, MD, BMC/BUSM family medicine; Alexa Bragg, BS, BMC/BUSM
family medicine; Afi M.

Semenya, MD, MPH, BMC/BUSM family medicine; Marielle Baldwin, MD, MPH,
BMC/BUSM family medicine; Jessica Howard, MA, MPH, BMC/BUSM family
medicine and Stephen A. Wilson, MD, MPH, BMC/BUSM family medicine.

These findings appear as a Perspective in the Journal of General Internal Medicine.

Funding was provided by the Boston University Center for Antiracist
Research.


========================================================================== Story Source: Materials provided by
Boston_University_School_of_Medicine. Note: Content may be edited for
style and length.


========================================================================== Journal Reference:
1. Katherine Gergen Barnett, Rebecca Grochow Mishuris, Charles
T. Williams,
Alexa Bragg, Afi M. Semenya, Marielle Baldwin, Jessica Howard,
Stephen A.

Wilson, Jayakanth Srinivasan. Telehealth's Double-Edged Sword:
Bridging or Perpetuating Health Inequities? Journal of General
Internal Medicine, 2022; DOI: 10.1007/s11606-022-07481-w ==========================================================================

Link to news story: https://www.sciencedaily.com/releases/2022/03/220330111341.htm

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