Reconnecting the Patient: Why Telehealth Policy Solutions Must Consider the Deepening Digital Divide

Abstract

smartphones, and broadband internet, will also have greater access to healthcare through telehealth if it is more fully implemented into the norm of healthcare delivery. However, what research has already shown, and what needs to be further explored, is the audio-only option that was used by many to provide telehealth during the pandemic as well as the populations that were reached. This Article hypothesizes that telehealth can and will thrive if telephone or audio-only access continues to some degree to be offered to provide healthcare for the populations who critics are quick to say cannot benefit from telehealth. While the audio-only modality of telehealth is not appropriate clinically for every healthcare situation or each individual's needs, there are still many who may otherwise benefit from its availability. Further, in addition to the audio-only telehealth modality option, efforts can and must be made to explore creating alternative places and spaces to offer both audio/visual telehealth options to these same populations. Education to enable individuals to learn how to use technology appropriately will also be a critical component. Finally, designers of these technologies for telehealth must make sure inclusion for all is at the forefront of design. In order to implement these mechanisms, policy solutions may come to bear on this to ensure equality. Telehealth is not merely as good as the technology that brings it to us but as versatile as the methods by which we enable people to have access and the regulatory framework to likewise allow for its cohesion as demonstrated by issues like how we define telehealth (i.e., if expanded to include audio-only modality) and whether or not reimbursement is offered. This Article will attempt to untangle the complicated web of providing telehealth to those populations it is potentially capable of further alienating from access to healthcare including: 1) race/minority populations, 2) aging adults, 3) individuals with disabilities, 4) non-English speakers, 5) individuals living in rural areas, 6) socioeconomic class, and 7) children, in order to advance the argument that telehealth can be successful in providing healthcare access to these populations. Rather than suggesting that telehealth simply "cannot work" for these populations, instead consideration can and must meet these individuals through technology, access, and policy developments. First, this Article will explain how telehealth is defined and how the definition has and can continue to influence policy development. Next this Article will explore the issues surrounding the "digital divide" and how this relates to telehealth use. Then this Article will discuss how access to technology impacts particular populations. This Article will then consider legislation and policy developments both at the federal and state level that have emerged thus far that could help overcome challenges of accessibility, affordability, and useability. Finally, this Article will offer policy recommendations for ensuring that the delivery of telehealth can be accessible to those populations with potentially less access to technology to ensure telehealth's successful availability and use for these populations can continue beyond Covid-19.

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