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Health equity in telehealth

It is our shared responsibility to ensure equal access to quality telehealth care for everyone. We can do that through improvements to telehealth workflow, staff training, and community resources. We should also meet the needs of underserved populations in our communities.

What is health equity?

Health equity in telehealth is the opportunity for everyone to receive the health care they need and deserve, regardless of social or economic status. Providing health equity in telehealth means making changes in digital literacy, technology, and analytics. This will help telehealth providers reach the underserved communities that need it the most.

Underserved communities often include:

  • Low income Americans
  • Rural Americans
  • People of color
  • Immigrants
  • People who identify as LGBTQ
  • People with disabilities
  • Older patients
  • People with limited knowledge of the English language
  • People with limited digital literacy
  • People who are underinsured or uninsured

Underserved communities often lack equal access to health care, leading to consequences such as:

  • Higher mortality rates
  • Higher rates of disease
  • More disease and illness severity
  • Higher medical costs
  • Lack of access to treatment
  • Lack of access to health insurance

Barriers to telehealth access may include:

  • Lack of video sharing technology, such as a smartphone, tablet, or computer
  • Spotty or no internet access
  • Lack of housing or private space to participate in virtual visits
  • Few local providers who offer telehealth practices
  • Language barriers, including oral, written, and signed language
  • Lack of adaptive equipment for people with disabilities

Equal access in telehealth

There are many ways to improve access to telehealth. This will help new patients feel welcome and comfortable.

  • Make materials accessible in different formats and multiple languages.
  • Use images and words in your online communications for patients with low literacy.
  • Measure patient satisfaction with post-visit surveys to improve service. Knowing what your patients need will help them feel more comfortable with virtual visits.
  • Use inclusive patient intake forms that ask about access to technology and patient preferences. This could include language and pronoun preferences.
  • Ask if your patients need assistive devices to participate in virtual visits.
  • Encourage staff to learn how to broaden telehealth access. Consider sending internal news and progress related to accessibility.
  • Include accessibility options within your telehealth programs. This could include screen readers or closed captioning options.
  • Allow extra time in virtual visit appointments for patients that may need support in getting online.
  • Use technology designed with equity in mind when it comes to speech recognition and health prediction algorithms.
  • Encourage all patients to get involved in planning and implementing health equity. This could include:
    • Sitting on a board or committee
    • Providing input on materials or procedures
    • Conducting sensitivity training
  • Look for skills and experiences within your team, including:
    • Cultural competency
    • Connections to the local community
    • Experience working with underserved patient groups
    • Fluency in languages other than English

Staff and provider health equity education

A successful telehealth practice includes providers and staff who know how to meet their patients’ needs. Support your staff in understanding accessibility challenges and how to overcome them.

Here are a few ways your practice can promote health equity:

  • Create a flexible telehealth workflow that allows for quick changes and improvements. This will help you meet the needs of your local community with little disruption.
  • Plan time for staff and provider training. This includes training in areas such as cultural sensitivity and accessibility requirements. Allow additional time to implement this training.
  • Consider a dedicated telehealth support team or staff member. This might mean shifting staff roles or hiring additional employees. Having telehealth support will help more patients successfully participate in virtual visits.

For more information on health equity training and education:

Advancing Health Equity at Every Point of Contact — from the U.S. Department of Health and Human Services (HHS)

Health Disparities Resources — from HHS

Health equity for special populations

There are numerous ways telehealth can support and improve health care for underserved patients.

Telehealth and LGBTQ+ patients

LGBTQ patients often lack accessibility in rural areas and face discrimination in health care settings. Find more information about how telehealth can support LGBTQ+ patients.

Telehealth and older adults

Many older patients are tech savvy with smartphones and tablets. Others will need step-by-step guidance to participate in virtual visits. Find more information about how telehealth can improve access to health care for older patients.

Information to share with your patients

The basics of telehealth (PDF)

Can I use telehealth for my child with special healthcare needs?

How do I schedule a telehealth appointment?

More resources:

Health Equity — from the Centers for Disease Control and Prevention (CDC)

Providing Health Literate Virtual Health Services  — from National Academies of Sciences, Engineering, and Medicine

Telehealth and Health Disparities — from the Agency for Healthcare Research and Quality

Innovative Virtual Care Strategies — from the Health Resources and Services Administration (HRSA)

Guidance on Nondiscrimination in Telehealth — from the Department of Health and Human Services Office for Civil Rights

The Use of Telehealth for Disability Evaluations in Medicine and Allied Health — from the National Academies Press (NAP)

A Practical Guide for Implementing the Digital Healthcare Equity Framework — from the Agency for Healthcare Research and Quality