The Digital Divide in Healthcare: Is Telemedicine Widening or Closing the Gap?

The high mortality and suffering during the COVID-19 pandemic definitely pushed forward long-needed changes in the healthcare system. At that time, telemedicine emerged as a boon, turning the convenient option of prioritizing health with virtual doctor visits into a reality. According to a study by the University of Health and Science, the percentage of sick individuals using telemedicine increased from 2.5% in 2019 to 51% in 2020. This controlled experiment taught us a lot about the efficacy of telemedicine.

Furthermore, telemedicine offers many benefits, including:

• Establishing direct contact with patients in remote areas or individuals with limited mobility.
• Patients save energy and time, as well as reduce the cost of traveling to and from treatment.
• Both patients and doctors save time due to increased convenience and flexibility.
• Maintain continuity of care even in public health emergencies.

Presently, telemedicine has become a means of providing quick service to patients, but at the same time, it has also become the cause of many pre-existing inequities, such as the digital divide in healthcare.

Digital Divide in Healthcare:

The “digital divide” refers to the gap between those who have easy access to computers and the Internet and those who do not. Among many other problems, the digital divide has been a jam in the healthcare industry. These jams are as follows:

• Lack of access to necessary technology (e.g., smartphones, computers, internet)
• Lack of digital literacy or technology use among the elderly, as well as rural populations, and racial and ethnic minorities
• Language barriers
• Problems older patients face in adopting technology
• Individuals with serious mental illnesses

The Telemedicine Access Triad

Effective video visit systems meet the three essential requirements:

• An electronic device with a video function
• A reliable high-speed internet connection
• Basic good digital skills

While video visits may be a more cost-effective option, there are technical barriers. Additionally, these can impact a doctor’s ability to perform a thorough, accurate visual assessment and build a positive personal relationship with patients.

Insights from the patient’s perspective

A study that compared patients who had access to video visits to those who had access to telephone visits among more geriatric patients revealed:

• 89% had some type of device
• 67% were able to access the internet regularly for tasks such as bill payments and shopping
• 78% still preferred in-person visits
• 67% expressed interest in trying video visits
• 67% of patients reported that the main barrier was a lack of confidence in using video visit technology.

Concern and desire for assistance

Patients openly described their fears:

“I am afraid of video visits, I don’t know what they are and how to use them. Also, I am not sure if they are better than phone visits. What is the difference between a video call and a voice call? No one has ever explained the difference and the importance to me.” Most people also expressed a strong need for live assistance:

• “I would love to learn how to use the internet and shop online. I have a laptop, but I’mn’t well aware of doing these things.”
• “I think it would be great if people could come to my house and help me set up the technology. I know a neighbour who helped me last time.”

Healthcare staff perspectives

Clinical support staff shared several key insights:

• 75% were using video visits, but in the event of a breakdown, they were often converted to a phone call.

Several issues were identified. The most common were:

• Forgetting login credentials
• Difficulty with pre-visit technical requirements
• Not being able to turn off pop-up blockers
• Keeping up with patient portal updates
• Lack of necessary tools or a reliable internet connection

One staff member added:

“So, if a virtual visit is impossible for a particular problem, it’s common to convert such a visit to a telephone call because they usually can’t do a virtual visit.”

Bridging the Gap: A Multi-Pronged Approach

A few ways to make telemedicine widespread and authentic are through this strategy:

1. Patient education and empowerment:

• Detailed and step-by-step explanation of the benefits of video visits compared to voice calls
• Step-by-step manuals on telemedicine platforms
• Addressing the security issues of home-based video calls

2. Technical support and training:

• Learning centres in the community or best through a technical supporter.

3. Improving access:

• Partnering with internet providers to offer low-cost plans for patients
• Device loan programs for those who cannot afford their own devices
• Creating community tech centers in underserved areas

4. Facilitating the user experience:

• Streamlined login processes
• User-friendly interfaces designed with input from various patient groups
• Multilingual support for non-English speakers

5. Policy and systemic change:

• Advocating for broadband internet as a public utility
• Reimbursement parity between video and in-person visits
• Integrating telemedicine training into medical education

Way Forward: Telemedicine as a Tool for Health Equity

The short-term massive increase in telehealth due to the COVID-19 pandemic has highlighted the immense potential and concerns of this technology for healthcare delivery.

Online psychiatrist has the potential to provide easier access to care for many patients, but it can also be detrimental to existing healthcare inequities if the digital divide is not adequately addressed. In the future, telemedicine, which acts as a tool that reduces rather than widens the gap in healthcare, should be the main goal of all stakeholders. This will also include adopting advanced technology along with increasing digital literacy, dealing with linguistic and cultural issues, and securing telemedicine platforms.

Telemedicine can not only help avoid the problem of tech-accessibility but also make healthcare more equitable by including everyone. The future of healthcare truly lies in the use of cutting-edge technology, as well as making it affordable and accessible to the general public. An online psychiatrist can treat any mental health issues, such as depression, anxiety, dementia, and many others.

In today’s times, a movement is needed to make healthcare easily available to citizens. Support measures that provide wider applications to telemedicine (volunteers will be trained free of cost at your local technology centers), so that everyone can benefit from it. You can also tell your people about the benefits of virtual care. You have to adopt your own methods to make life healthier using telemedicine.