Patient-Centered Care

#ATA2020: Expanding Telehealth Access to Reach Populations in Need

How can developers and providers make the vital service more equitable? Conference panelists shared insights and advice.

Kevin Joy

Kevin Joy is the managing editor of HealthTech. He previously worked in content marketing for a major university health system and as a features reporter for the Columbus Dispatch.

Although it’s widely seen as a way to democratize and expedite care delivery, telehealth must continue to evolve to serve the needs of a diverse patient population.

Providers and IT teams should look beyond issues of public safety to acknowledge technology access, connectivity, language barriers and coverage restrictions, panelists at the American Telemedicine Association’s 2020 conference noted this week.

Despite broad temporary waivers allowing Medicare and Medicaid recipients to use the services more widely during the COVID-19 pandemic, “telehealth and virtual visits were built for wealthier and high-income people,” said Abner Mason, founder and CEO of ConsejoSano, a solution designed to help providers engage with multicultural patient populations.

“We have a huge opportunity to increase access and engage with everyone,” he said.

This is exactly why telehealth developers and care providers need to address usability concerns for people with disabilities, other panelists said. And they must study how recent accommodations for elderly and low-income patients have enhanced care delivery — and what effects restricting this platform again could have in the future.

Improving Telehealth Services for Patients with Disabilities

Developments are underway to improve the telehealth experience for patients with visual or hearing impairments, said Christopher Patnoe, head of accessibility programs and disability inclusion at Google.

He noted ongoing work to develop live transcription services in more than 70 languages, which would allow both sides of a telehealth exchange to understand each other in real time. In addition, Patnoe said, “We now have the ability to add captions free for anyone in Google Meet,” a video-communication service that can be made HIPAA-compliant.

Jay Beavers, a principal development lead at Microsoft, cited the value of eye-tracking devices and their potential to integrate with virtual care platforms for those who can’t speak or type.

Some technologies that support everyday consumer habits — voice-activated commands, talk-to-text functionality, video chat, even audiobooks — originated from products designed for people with disabilities, said Brooke Ellison, an associate professor of healthcare policy and ethics at Stony Brook Medicine.

Transcription services will play a key role as telehealth services evolve, said Christopher Patnoe of Google.

Using creative thinking to adapt to their environment is a way of life for members of this population, she added, and the strategies can play an influential role in telehealth.

“Those are the kind of engineers people are looking to as we try to re-envision our world,” said Ellison, who has been paralyzed from the neck down since she was hit by a car in seventh grade, “not just out of charity but because we want to make people’s lives better, so they are active participants in society.”

Addressing Social Determinants of Health to Improve Care Delivery

Prior to the pandemic, patients covered by Medicare and Medicaid couldn’t access telehealth without a number of restrictions. Medicare members, for example, once were limited by geography and applicable reasons for a visit. Medicaid is administered by states, which led telehealth coverage policies to vary widely.

Broader permanent coverage of telehealth services could be a game changer, making preventive care less of a barrier for patients who lack transportation, can’t secure childcare or who live in rural areas.

“We’re running into the same concerns as everyone else — fears around when these executive orders are going to end,” said Sydney Etheridge, director of the healthcare investment program at Planned Parenthood Federation of America.

Outreach remains critical as usage expands. Texas Children’s Hospital deployed television ads, social media and direct mail to promote the availability of telehealth, said Laura Laux Higgins, the hospital’s director for strategic projects. Staffers were trained with scripts to help assure parents new to the platform that virtual care is safe and effective.

Still, more work remains. Some health systems and insurers may go further to invest in the tools and get them in the hands of patients most in need.

“How can we have digital technology and not be prescribing Wi-Fi or not prescribe a smartphone?” said Grace Cordovano, a patient advocate and digital health consultant. “This is something that needs to become mainstream.”

Keep this page bookmarked for articles from the event. Follow us on Twitter @HealthTechMag as well as the official organization account, @AmericanTelemed, and join the conversation using the hashtags #ATA2020 and #GoTelehealth.

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