Telehealth

As society works to address the systemic barriers that contribute to the maternal health crisis, it is important to recognize the role that telehealth could play in improving the United States’ maternal health outcomes. Policymakers should take the following into consideration: 

As high-speed internet becomes increasingly important as a resource for cardiovascular disease (CVD) prevention and management services, gaps in digital infrastructure may have a detrimental impact on health outcomes. Using national census and the Centers for Disease Control and Prevention (CDC) data from 2018, researchers evaluated state-level rates of household internet access and age-adjusted cardiac mortality.

The Commerce Department’s Economic Development Administration (EDA) awarded a $4.5 million Coronavirus Aid, Relief, and Economic Security (CARES) Act Recovery Assistance grant to the Port of Lewiston, Lewiston, Idaho, to expand internet connectivity for commerce, public health and safety and learning in North Central Idaho. This project will support the construction of a 95-mile segment of fiberoptic cable running from Moscow to Grangeville. This EDA grant will be matched with $1.1 million in local funds and is expected to create 120 jobs, according to grantee estimates. 

Healthcare is facing a new frontier, as the industry has seen a boom in digital health tools and technologies on both the patient and provider side. An explosion of health dat has also been driving increasingly sophisticated predictive and prescriptive insights into individuals and populations. Unfortunately, this frontier has proven to be hostile to marginalized communities. There is a growing digital divide, where healthcare technology has actually posed challenges, instead of benefits.

The Department of Commerce’s National Telecommunications and Information Administration awarded an $18.9 million Tribal Broadband Connectivity Program (TBCP) grant to the Inter-Tribal Council of Nevada (ITCN). This grant will fund high-speed internet infrastructure deployment, use, and adoption projects to improve connectivity across Tribal lands.

The Department of Commerce’s National Telecommunications and Information Administration (NTIA) awarded $143,639,693.50 in funds from the Consolidated Appropriations Act, 2021 to Tribes in California and Washington.The awards provide funds for high-speed internet infrastructure deployment projects through the Internet for All Initiative’s Tribal Broadband Connectivity Program for the Hoopa Valley Tribal Council and Yurok Telecommunications in California and the Spokane Tribe of Indians in Washington.

Telemedicine’s ultimate success will depend in large part on technology—how seamless patients will find the process, and the digital divide that now keeps many physicians from offering telehealth services and patients from accessing them.

For patients to participate in telehealth encounters, they have to use a number of proprietary, health system-specific portals and platforms. That can be challenging for many older adults and minority groups. Effective virtual care depends on digital fluency, meaning they need to be able to engage in all aspects of digital technologies, from accessing the internet to navigating telehealth applications and performing basic troubleshooting.

In August 2020, the Veterans Health Administration’s (VHA) Office of Connected Care recognized the growing demand for patients’ access to video-based virtual care, and that many patients lack a video-capable device, or the internet connection required to access this care. To bridge “the digital divide, which exists between individuals with access to a device and connectivity and those who [lack that] access,” VHA introduced the digital divide consult.

The United States has long struggled with a health care system that is both expensive and often inaccessible when it comes to providing certain populations with equitable care. The White House and Congress acted quickly to transition patients to telehealth during the height of the COVID-19 pandemic. However, the future adoption and use of telehealth will depend on how the U.S. health care system addresses coverage and reimbursement, medical licensure, and service modalities.