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\u201cUsing qualitative data and our own experiences as front line primary care physicians we discovered that while digital access is necessary<\/em>, it is not sufficient <\/em>in redressing disparate engagement with telehealth,\u201d says corresponding author Rebecca G. Mishuris, MD, MPH, MS, assistant professor of medicine at BUSM, and primary care physician and Chief Medical Information Officer of the BMC Health System.<\/p>\nAccording to the researchers, a key component of these structural inequities is the digital divide, driven partly by \u201cdigital redlining.\u201d Digital redlining is the modern day manifestation of redlining that perpetuates health inequities and structural racism by maintaining barriers to technological access, further perpetuating lack of healthcare access.<\/p>\n
Based on their experience as well as data about their patients\u2019 access to healthcare, virtual and otherwise, Mishuris and her colleagues theorize that two additional barriers to equitable telehealth exist: digital fluency, the ability to use digital tools efficiently and effectively; and the capacity for health advocacy, a patients\u2019 ability to advocate for their own health needs.<\/p>\n
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\u201cWithout addressing these critical, less often discussed elements of telehealth implementation, it is our belief that telehealth will fall short of its promise and rather than mitigate health inequities, will perpetuate health inequities in the very communities that stand to benefit most from its implementation,\u201d says co-author Katherine Gergen Barnett, MD, clinical associate professor of family medicine at BUSM and Vice Chair of Primary Care Innovation and Transformation at BMC.<\/p>\n
In an effort to overcome the barriers of device and broadband access, digital fluency and health advocacy to mitigate current inequities in digital health engagement, the researchers propose a three-pronged approach of creating federal and state policies to democratize access to telehealth. \u201cBy establishing platform standards for accessing telehealth, and supporting societal and health system investments to increase health literacy, advocacy and technology fluency, we can begin to address the disparities in telehealth engagement and healthcare access,\u201d says Mishuris.<\/p>\n
Collaborators include Jayakanth Srinivasan, PhD, research associate professor at Boston University\u2019s Questrom School of Business; Charles T. Williams, MD, BMC\/BUSM family medicine; Alexa Bragg, BS, BMC\/BUSM family medicine; Afi M. Semenya, MD, MPH, BMC\/BUSM family medicine; Marielle Baldwin, MD, MPH, BMC\/BUSM family medicine; Jessica Howard, MA, MPH, BMC\/BUSM family medicine and Stephen A. Wilson, MD, MPH, BMC\/BUSM family medicine.<\/p>\n