As telehealth use soared this past spring, health systems were confronted with a problem: not all patients have access to high-quality internet.
It’s not a new problem, but it took on newfound importance as health systems were forced to shift more and more patient appointments online.
It’s frustrating to be “in the middle of a telehealth visit and it drops or you can’t hear someone,” said David Entwistle, CEO of Palo Alto, Calif.-based Stanford Health Care. For some patient populations, that could go beyond frustration and become an issue of access to care.
“What I do worry about is that there’s some socio-economic demographics that are not going to have access to (this) technology,” Entwistle added.
Health systems are still grappling with how to address that challenge.
During the pandemic, clinicians have been able to replace some appointments with audio-only telephone visits. However, payment for those services from CMS might expire with the public health emergency.
Dr. R. Lawrence Moss, CEO of Jacksonville, Fla.-based Nemours Children’s Health System, suggested that internet access could be the next social determinant of health that health systems target. All CEOs in Modern Healthcare’s Power Panel survey said their organizations need to address patient issues beyond traditional healthcare, including social determinants.
That typically includes addressing access to food or transportation, but not internet.
Internet access is one of many social factors that Nemours is considering, Moss said.
“Just like I believe the health system needs to play a role with partners in ensuring that every child has access to high-quality food, every child also needs access to high-quality digital connectivity,” Moss said. “A decade ago we wouldn’t have said that, but it’s a different world now.”
Roughly 6.5% of Americans lacked access to wired broadband that met the Federal Communications Commission’s speed benchmark in 2017, according to a report the agency released last year. About 26.4% of rural Americans lack that access, an issue that HHS, the FCC and the Agriculture Department said they’ll tackle as part of a new Rural Telehealth Initiative.
Even if patients do have internet access, they might need help learning to use health systems’ emerging digital tools.
Carilion Clinic in Roanoke, Va., is working to stand up Apple Genius Bar-style technology support stations in its surrounding community, as part of a program to better answer patients’ questions about using the health system’s tech tools and encourage them to adopt the capabilities, said Nancy Agee, Carilion’s CEO. The system hopes to open the first station in a few months.
Given COVID-19, Agee said Carilion is working on possibilities for creating a “virtual” tech bar. The health system is planning to use a new patient education program, which it’s already using to let clinicians assign short educational videos to patients about some conditions and procedures. A set of videos on how to use Carilion’s digital tools, such as its apps, could fit into that resource, Agee said.