How the future
of telemedicine
accessibility
impacts virtual-first
healthcare

The United States faces significant and complex healthcare challenges—two being chronic disease and the long-term effects of a pandemic. A virtual-first approach to healthcare—one that leverages technology to address issues early and efficiently to improve outcomes and reduce costs—could be a creative solution. But the future of telemedicine accessibility remains a critical consideration to expanding essential healthcare treatment services.

Telemedicine and telehealth are the front line of healthcare's virtual future—but to realize that future, everyone has to be able to access it. Despite its potential, information technology creates digital divides that separate those with telemedicine accessibility from those without it. And that gap—whether it's caused by education, location or socioeconomic status—is growing.

With telemedicine and access to care, technology is both a challenge and an answer.

In February 2020, telemedicine made up less than 1% of primary care visits and by April, that number exploded to almost 43.5%. That growth curve will likely flatten as the COVID-19 pandemic is brought under control, but industry experts expect a few long-term evolutions.

• Telemedicine will likely become a mainstream offering for certain specialties and best-fit use cases.
• Access to telemedicine options will influence how patients choose doctors, hospitals and health systems in the future.
• Telemedicine accessibility will streamline access to specialists and reduce wait times at hospitals.
• Telemedicine can enable better chronic disease management, treatment compliance, and improved care outcomes.

Bright as the future of telemedicine may seem, it is not guaranteed for everyone. The digital divide persists—and while it does, telemedicine accessibility may not be equal.

To understand the digital divide, look at the current state of digital access. The Pew Research Center found that 59% of lower-income parents who had children in school said that their children would likely face at least one digital obstacle to completing their work. And 25% of adults ages 65 and older never go online, Pew reports.

But income and age are not the only barriers to telemedicine.

Where patients learn, live, play and work affect their health outcomes and their risks to quality of life. Social determinants of health include economic stability, neighborhood and environment, social and community context, and education access and quality.

Nonwhites and people who live in rural areas are significantly less likely to use telehealth services, according to the Journal of Telemedicine and Telecare. The journal also reports that Black patients, older patients, patients who live in urban areas, and patients who receive Medicare or Medicaid or self-pay for medical services were far less likely to schedule full telehealth visits.

Other potential barriers to telemedicine accessibility and telehealth access to care include:

• Broadband access and digital literacy. The internet is a foundation of remote care, but access alone is not enough to keep up with the increasingly sophisticated demands of telemedicine. Telemedicine can incorporate video, images and providers across broader geographic areas as specialists and new technologies are introduced. Patients without access to a broadband network may have limited access to virtual care. In addition, digital literacy can pose challenges to those that are not computer-literate. Having access to technology does not necessarily mean understanding how to use that technology. The pandemic helped expose challenges in patient digital literacy, especially among older and minority patients, helping to make telemedicine accessibility a challenge, even though the technology was in place.
• Disability. People with disabilities face barriers to telemedicine, too. If a telemedicine user interface lacks captions, magnification, color or sign language capabilities, it limits disabled access to services and benefits.
• Under-resourced practices. Larger providers such as hospitals and multistate medical groups might have been able to step easily into telemedicine. But smaller practices, which usually have fewer resources, might face difficulties in expanding their services.