Defined by the World Health Organisation (WHO) as a mode of remote healthcare services delivery through modern information and communication technologies (ICT), the emergence of telehealth is heralded by some as marking the advent of an age of health equity. However, while this new paradigm may mean greater accessibility for some, it may have the opposite effect on others. To begin an analysis of healthcare accessibility, it is essential to understand what is necessary for an effective doctor-patient encounter under this new model.
Firstly, the patient must be aware of a telehealth service that will provide care to them as well as the means of getting contact. Then, when the appointment is booked, the patient must have the resources to attend the appointment and understand the instructions of the healthcare professional. Lastly, after the clinical encounter, they must have or have been directed to resources that would allow them to make use of the advice of the healthcare professional.
A break in any one of the above links would mean a lack of access.
Paradoxically, the increasingly online nature of healthcare advertising creates situations where, in order to catch wind of a new service geared at increasing accessibility in hard-to-reach areas, patients must have access to technology in the first place. Programs that try to move these notices offline are hampered by lack of identification of and accessibility to hard-to-reach populations.
The variety of resources necessary to attend an appointment, despite seeming straightforward, can actually be quite complex depending on the context of the patient. Most critics of telehealth point out that, in order to access any kind of service online, the patient must have some kind of working device with a WiFi connection. This alone can be difficult for many people in desperate need of healthcare. However, lack of access to technology can intersect with many other issues such as low proficiency in English, unstable jobs that make it difficult to isolate time for a healthcare consultation, and other duties that require constant attention. All of these problems, in varying combinations, may manifest in patients and obstruct their usage of telehealth services and/or their ability to incorporate the advice of medical professionals into their lives.
Of course, other concerns remain aside from basic accessibility such as access to specialists for certain diseases or conditions and fees for medicines. In this instance, outreach programs such as mobile clinics may be among some of the most efficient ways of catching those who fall between the cracks.
While telehealth is, without a doubt, an innovative and powerful tool for achieving health equity, it is important to remember that the effectiveness of new technology can still be hampered by the socio-economic problems that made it necessary in the first place. While this article tries to provide a brief overview of the populations left behind, it is still short and far from thorough. Further research is needed across a variety of disciplines such as medical anthropology, medicine, and bioethics to truly comprehend and fulfill the needs of different communities.
This article is written in collaboration with the Health and Human Rights (HHR) subcommittee of the University of Toronto International Health Program. If you found its contents interesting, please consider attending the 2021 HHR Conference and/or submitting an abstract to the 2021 HHR Research Poster Fair.
More information on seminars, speakers, and scheduling can be found on our Facebook page: https://bit.ly/2VHNt7I
Event: UTIHP HHR Research Poster Fair 2021
Time: March 9th, 2021 - March, 12th 2021
Topic: The Future of Healthcare Accessibility Through Telehealth
Presentation format: Online poster fair
Abstract submission: http://ow.ly/323T50Cy9t0
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