INDIANAPOLIS (WISH) — Access to health care has changed radically since the novel coronavirus was declared a pandemic on March 11 by the World Health Organization. Out of necessity, clinicians were only seeing patients virtually through Skype, FaceTime or other electronic communication platforms.
But even as the country reopens, this type of digital doctor-patient relationship is here to stay.
“About 30% of visits we used to have in-person will be via telehealth in the future,” Dr. Paul Rothman, Dean of the Medical Faculty at Johns Hopkins University and CEO of Johns Hopkins Medicine, told virtual audiences during the OurCrowd Pandemic Innovation Conference on Monday.
While telemedicine can’t replace human-to-human interaction, it does have it’s benefits. People don’t have to travel and are often more relaxed during appointments because they are in the comforts of their home. Doctors can also get a sense of a person’s living environment, which might be having an impact on their health status.
However, keeping office visits to a minimum has its downfalls, especially for those in rural areas without internet access. Minority communities are disproportionately impacted by these circumstances. Instead of fostering better health care, an over-reliance on telehealth by practitioners might further health inequities.
News 8 spoke with Joy L. Lee, PhD, research scientist at the Regenstrief Institute and assistant professor of medicine at Indiana University to get her thoughts. Here’s what she had to say:
Q. What are the benefits and drawbacks of telehealth for minorities?
Dr. Lee: Telehealth can connect a lot of patients to their doctors. But it can also leave a lot of patients behind. Because telehealth visits allow patients to virtually see their doctors from anywhere with internet access, it can be really convenient for patients in rural communities who live far away from their doctors, or patients who can’t easily take off for work to drive to the clinic, wait, see the doctor, and drive back. Patients in certain specialty, vulnerable populations, like those with HIV or with rare diseases, may also benefit. Telehealth saves time and expands access.
At the same time, video visits require a stable Internet connection and that puts many older, and poorer patients at a disadvantage, including many minority patients. For patients with language and communication barriers—either because they don’t speak English fluently, or if they are hard of hearing—video and phone visits can also be a challenge to hear and understand the doctor through a different platform and medium.
Q. What are your thoughts about a patient speaking about health conditions in the comforts of their own homes?
Dr. Lee: Doctor offices can be intimidating for some patients, especially for communities that have not been treated well by health care. For some patients then, seeing a doctor from the comfort of their own home may be preferable. But that’s really hard to say. As many people have discovered during shelter-at-home, particularly those with young kids, it can be difficult to find a quiet space to talk to a doctor about personal health issues. And for some people, going to the doctor’s office can be comforting, because doctors seem quite authoritative and can bring a sense of assurance.
Q. What role do you think telehealth plays as it relates to health disparities?
Dr. Lee: I don’t think health information technology tools are ever the main solution or the main cause of problems like health disparities. Of course, these are many use cases for telehealth—it can be used to make it easier for some people to access their doctors, and in that way, that may help to decrease some health disparities. But addressing disparities using telehealth really requires an intentional focus by doctors and the clinics and health systems that they work for to fix the problem. Having video capability isn’t going to fix anything if it’s not being thoughtfully used, if people don’t have access to the internet, if the doctor doesn’t speak the same language as the patient, or if efforts aren’t being made to make sure patients without video access aren’t left behind.
In the same way, improving patients’ access to information is great, but not if it is not coupled with outreach efforts or education to make sure patients know that they have access, and then if they have help in interpreting the information that they find, and also if they know that they can talk to their healthcare provider about information that they find.