Telehealth without ancillary diagnostic services and in-person follow-up may not be enough to achieve equity in access in underserved communities—but you can't just abandon patients who would benefit from it, either.
Telehealth has the potential to greatly expand the reach of medicine, not only in remote areas around the globe, but also for various socioeconomic groups. Like other healthcare technologies, it has the potential to disrupt established patterns of care, lower costs and make access to care more convenient.
But is that enough?
“Many experts have suggested that telehealth services for underserved populations require integration with the wider healthcare system; however, they require more than that,” Lori Uscher-Pines, a policy researcher at the RAND Corporation, and Ateev Mehrotra, M.D., an associate professor of healthcare policy and medicine at Harvard Medical School and a hospitalist at Beth Israel Deaconess Medical Center write in a Health Affairs blog post.
“Telehealth requires integration into a well-functioning healthcare system that has the capacity to address all the additional patient needs that telehealth generates.”
In fact, after evaluating two services for the underserved, the researchers learned that telehealth can actually stress the healthcare system further by identifying problems that require longitudinal care when there aren’t enough resources to see patients in-person in a timely manner.
Of course, that doesn’t mean systems should abandon telehealth or the patients who might require in-person care after using it.
Solutions, the authors write, might include the following:
- Avoid starting telehealth programs in communities that are at capacity.
- Work with local providers to formally create slots for telehealth patients who require in-person follow-up.
- Create hybrid brick-and-mortar and telehealth programs.