Tag Archives: providers

HOW CAN POLICYMAKERS AND PROVIDERS ADDRESS THE CHALLENGES OF EQUITABLE ACCESS TO TELEHEALTH

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There are several significant challenges to ensuring equitable access to telehealth, especially for underserved groups. Policymakers and healthcare providers must take a multifaceted approach to overcoming these barriers.

One of the most immediate barriers is the digital divide in access to broadband internet and technologies like smartphones, laptops, and tablets needed to utilize telehealth services. According to the FCC, an estimated 21.3 million Americans still lack access to fixed broadband service at threshold speeds. Those without home internet access are disproportionately low-income individuals, residents of tribal lands, people of color, older adults, and those living in rural areas.

Policymakers should increase funding and incentives for expanding high-speed broadband infrastructure, especially in underserved rural and tribal communities. The recently passed Infrastructure Investment and Jobs Act allocates $65 billion toward expanding broadband access across the country. Providers can work with community groups and patients to distribute free or low-cost tablets and mobile hotspots in areas without home internet access.

Lack of digital literacy remains a substantial barrier, as many individuals may not have the technical skills to operate telehealth platforms. Both policymakers and providers need to invest in digital skills training programs, offered either in-person or virtually, to help underserved groups learn how to use technologies like videoconferencing applications and patient portals. Community organizations like libraries can partner with healthcare entities to provide digital literacy classes and one-on-one technology assistance.

The affordability of Telehealth services and connectivity is another hurdle. While the infrastructure bill and some state policies have expanded access to affordable broadband internet plans for low-income households, data plans and connectivity costs can still prohibit regular telehealth use. Policymakers should consider expanding federal subsidy programs for health-related connectivity and mandate that telehealth services have no to low patient cost-sharing. Healthcare providers also need to offer flexible payment plans or work with community clinics to provide free telehealth access points for the uninsured.

Language and cultural barriers also marginalize many groups from equitable telehealth care. Both medical interpreters and culturally-competent health education materials must be made universally available. Policymakers should require and provider reimbursement programs should cover 24/7 access to qualified medical interpreters across all major languages, including ASL interpreters for deaf individuals. Healthcare entities must translate all telehealth informational materials and platforms into prevalent non-English languages and ensure culturally-tailored health messaging.

Privacy and security concerns could disproportionately deter underserved patients from engaging in telehealth. Policies like HIPAA and the Federal Trade Commission’s Telehealth rule help protect patient data privacy and security during virtual visits. More needs to be done to foster trust, especially among vulnerable groups. Providers must communicate clearly how they safeguard personal health information, obtain explicit patient consent, and provide multi-lingual privacy training. When developing new technologies, inclusive user-experience design and community oversight can help address privacy, automation bias and surveillance risk for marginalized populations.

Lack of access to sufficient broadband-enabled devices remains a hurdle for many. Beyond expanding low-cost options, providers should consider lending medical-grade tablets and laptops pre-loaded with telehealth applications for patient use, especially for those managing chronic illnesses requiring frequent care. Mobile health clinics equipped with telehealth capabilities could also travel to underserved communities to increase access points.

A comprehensive approach is needed involving coordinated efforts between policymakers, healthcare systems, community partners and patients themselves. By addressing barriers related to infrastructure, affordability, language, literacy, privacy and access to enabling devices – especially in marginalized groups – telehealth’s promise of expanded access to equitable care can be more fully realized. Ongoing community involvement and cultural competence will also be key to overcoming historical mistrust and building resilient virtual care models for underserved populations.

HOW CAN HEALTHCARE PROVIDERS ENSURE THAT PATIENTS HAVE ACCESS TO NECESSARY POST DISCHARGE SERVICES?

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Ensuring patients have access to necessary post-discharge services is critical for facilitating recovery and preventing readmissions. There are several strategies healthcare providers can utilize.

First, providers must conduct comprehensive discharge planning which assesses what services each patient will need after leaving the hospital such as medication management, wound care, physical therapy, skilled nursing, home health, etc. This planning should ideally begin on admission so there is sufficient time to coordinate everything. During the planning process, providers need to screen for any social determinants of health risks like food/housing insecurity which if unaddressed could negatively impact outcomes.

Second, providers need to verify that patients being discharged have all the necessary medical equipment, supplies, medications they require as well as instructions for how to use everything and who to contact with any questions or issues that arise. This often involves working with durable medical equipment companies, pharmacies, and home health agencies to ensure everything is in place and operational by the time patients leave.

Third, providers need to conduct patient education prior to discharge regarding their diagnosis, treatment plan, warning signs that should prompt contacting a provider, and how to self-manage their condition at home. This education often involves multimodal teaching methods like verbal and written instructions plus return demonstrations to evaluate comprehension. It is also important for education to involve family members or caregivers who will be assisting patients.

Fourth, providers need to make timely post-discharge follow up appointments with primary care providers or specialists, as appropriate, before patients leave the hospital. This involves direct scheduling of appointments which may require addressing any transportation barriers. Following up within 7-10 days of discharge has been shown to reduce readmissions. Additional interventions like transitional care clinics or in-home visits can help bridge the time until a follow up appointment occurs.

Fifth, providers need to leverage technology and community resources to support patients post-discharge. This includes ensuring patients enroll in remote monitoring programs if applicable for their condition and prescribed treatments which allow providers to keep tabs on vital signs and progress from a distance. It also means ensuring patients are aware of and connected to any applicable community-based support programs for things like Meals on Wheels, food banks, transportation assistance, adult day care, homemaking help, support groups, etc.

Sixth, providers need robust discharge communication with outpatient providers including primary care physicians and specialists. This involves sending timely and comprehensive discharge summaries that detail the hospitalization, procedures, treatments, changes to medications or treatments, follow up needs, and open clinical questions. Strong bidirectional communication helps outpatient providers take over care seamlessly and addresses any gaps preemptively.

Seventh, healthcare systems and institutions need to closely track metrics like 30-day readmission rates, ED visit rates, and patient/family experience surveys specifically focused on transitions of care in order to identify gaps, continually refine processes, and ensure accessibility of post-discharge services according to community need. This may require facilities partnering with community organizations, expanding existing programs, or piloting new initiatives based on data trends.

By implementing comprehensive discharge planning that begins early, verifying patients have necessary medical equipment and instructions, conducting proper patient/caregiver education, making timely follow up appointments, leveraging technology and community resources, sending robust communication to outpatient providers, and closely tracking post-acute outcomes – healthcare providers can significantly improve patients’ access to vital post-discharge services needed for recovery and meeting their goals of care. Coordinated, patient-centered planning from admit to well after discharge is key.