The past two years have underscored the long-standing but always disturbing reality that millions of Americans lack sufficient health care access. While the consequences have been particularly deadly during the pandemic, the challenges to overcoming this problem are nothing new.
Health outcomes are closely tied to race, income level, educational quality, location of residence, and more, as well as individuals’ genetics. Dozens of studies show that the higher a person’s wealth and income, for example, the lower their likelihood of illness and premature death, largely because wealthier people can afford resources that lead to improved health.
With the rise of digital health care, the U.S. faces a new health challenge: unequal access to broadband technology. Some 43% of adults in households making less than $30,000 a year — that’s more than 25 million American adults — lack a high-speed internet connection. Those with limited or no internet access can’t communicate online with their physicians, obtain electronic medical records, or access online health resources, all of which can improve health outcomes.
Many digital health products and applications offered today work most effectively with a broadband connection. Tools like smartphones, health monitoring devices, and cloud-based software applications can support health equity by closing communication gaps between patients and providers, enhancing consumer access to health care services and increasing consumers’ knowledge about their own health.
Technology and health care firms are already doing their part working to advance health equity and reach underserved communities. Here are just a few examples: During the pandemic, Doctor On Demand (now Included Health) provided on-demand virtual care to nearly 100 million people across the U.S. Microsoft developed and deployed Covid-19 screening and triage bots, mobile apps for field workers, and analytics for public health agencies. A collaborative effort through the Alliance for Better Health distributed Kinsa Health thermometers during the pandemic to community-based organizations and their members. And Fitbit is awarding up to $500,000 in products and services to early-career researchers improving health care access for underserved populations.
But private sector action is only part of the solution. Collaboration between business and government is needed at every level of American health care. That’s why the Consumer Technology Association, which I lead, has developed new recommendations to make digital health care more accessible for all Americans. These include the following strategies:
Lawmakers at the federal and state level should expand broadband coverage to reach rural and underserved areas. Telehealth can connect providers with patients for both urgent and routine care, which can improve patient satisfaction, increase access to specialist care, and decrease reliance on emergency departments. The infrastructure bill passed last week — which includes $42 billion in federal funding marked for broadband expansion and $14.2 billion to help low-income Americans afford broadband service — can help this effort. But the devil is in the details, and the administration will need to ensure the funds are used effectively and transparently.
Congress should also make permanent certain Medicare telehealth Covid-19 public health emergency waivers and flexible policies. Current Medicare laws and regulations limit coverage of telehealth to rural areas and create barriers to access, preventing patients from receiving continuing care from doctors across state lines, even as the shortage of physicians grows. Making these waivers permanent would also remove the arbitrary distinctions that bar telehealth care provided by specialized practitioners like physical therapists, occupational therapists and speech language pathologists. The pandemic showed the value of providing these services without unnecessary limitations, and action now can support broader public health goals.
American lawmakers and policymakers have an opportunity to learn from the Covid-19 crisis and ensure that every American has access to quality care in the digital age. They need to take it.
Gary Shapiro is president and CEO of the Consumer Technology Association and author of “Ninja Future: Secrets to Success in the New World of Innovation” (HarperCollins, 2020).
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November 12, 2021 at 05:00PM
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Broadband access: Health care's newest challenge - STAT
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