The COVID-19 pandemic has shined a spotlight on health disparities and systemic inadequacies associated with decadeslong underinvestment in public health.
At the same time, the need to socially isolate has accelerated virtual solutions to address access issues, contact tracing and primary- and specialty-care services in new ways—progress that’s not likely to be reversed.
Digital care gives patients and clinicians more flexibility around the time of encounter, where the encounter occurs, and what type of technology is used. What has happened around telehealth gives vivid meaning to the concept of meeting patients where they are and provides more opportunities for patients to receive care in the language they prefer.
However, for telehealth to be maximized, all of us must recognize access to technology as a social determinant of health. Like transportation, food insecurity and other fundamental services we now understand to be integral parts of a person’s overall health, lack of technology, internet availability and digital literacy also present barriers to accessing healthcare services.
Across the country, COVID-19 has disproportionately affected Black, Latinx and low-income communities—the same communities that are on the wrong side of the digital divide. Communities that are technologically underserved also are underserved for healthcare services and face higher healthcare risks.
With COVID-19 cases surging across the country, New York’s experience as one of the virus’ original epicenters, as well as home to one of our most diverse cities, provides valuable insight into the current challenge. In an effort to take a fresh look at the services and support we could offer our members during the pandemic, our health plan surveyed 1,000 New Yorkers to determine how digital and virtual care could meet their needs. We found that, while 82% of New York’s general population has access to reliable internet at home, almost a quarter of low-income households and nearly a third of Black and African American respondents do not.
In response to COVID-19, internet service providers worked quickly to expand internet access to New Yorkers who suddenly found themselves working, keeping up with family, attending classes, and accessing healthcare from home. The survey found that individuals and families in healthcare “hot spots” are more likely to report difficulties with internet access. At the same time, our survey highlighted another disparity: Some 78% of the general population reported they had access to two or more technology devices at home, compared with 69% of low-income households and 67% of Black and African American households reporting similar availability of devices.
Looking forward, it will be crucial for the healthcare industry to approach internet access as part of healthcare access. As we work to build stronger public health programs across the country, it will be important to include digital literacy programs and access to technology. Over the past few months, we have given serious consideration to how our health plan can help address this challenge. As healthcare organizations, many of us serve as the hubs of our communities, providing not only access to care, but also social services, from wellness classes to food support.
In some cases, the infrastructure already exists to address the digital divide at the community level. In addition to long-term strategies, there are quick wins, such as providing free Wi-Fi at all community locations, offering digital literacy courses in concert with existing wellness classes, and restructuring our physical spaces to welcome back patients and members, while dedicating private spaces equipped with technology that community members can use to access telehealth. As more consumers continue to use telehealth, healthcare organizations also need to give patients more integrated options, such as video, chat, texting and calls.
In response to the pandemic, national and state leaders issued emergency waivers of laws that had previously limited access to telehealth in Medicare and other programs. These changes were critical moves to which the market quickly responded, enabling telehealth adoption to take an important leap forward, and they should be made permanent.
At the same time, our survey findings demonstrate that it will be equally important to allocate new funding to ensure underserved communities are not left behind on access to technology. Without that step, the country risks further deepening health disparities long after this national crisis ends.