Telehealth expansion has been supported by many healthcare and government leaders in the post-pandemic world, including President Biden, as a way to ensure that everyone has access to coverage and essential health services.
Adding broadband access to rural or underserved communities, however, may not be a silver bullet that enables telehealth use in those areas, a new study shows.
This means that long-term care providers, particularly those in rural areas, need to make sure that digital literacy training and cultural factors are in place for telehealth use.
The study authors, publishing in JAMA Network Open, said they were most concerned with policymakers and whether they were viewing telehealth issues too narrowly.
Although the study, which looked at 170,000 Wisconsin Medicaid beneficiaries, supported the idea that telehealth helped remove geographic barriers to important healthcare services, the researchers concluded that actual telehealth use is separated by what they termed the “digital divide.” This divide includes a mix of factors including age, ethnicity and tech literacy.
“Although telehealth expansion has been touted as a low threshold policy intervention to expand access to care,” the study authors wrote, “leveraging telehealth to improve access for underserved populations will require more nuanced attention to the specific mechanisms linking telehealth and healthcare utilization to avoid inadvertently deepening disparities for select populations.”
After the pandemic, those who adopted telehealth skewed older, urban and female, the study found. Although the researchers held back on making a definitive conclusion for why this cohort would be more amenable to telehealth use, they speculated that it was broadly due to better knowledge and trust in the healthcare system. The study showed greater telehealth use for lower-income and educated individuals — but only for audio-only interventions, which are only a small fraction of telehealth care.
Although older adults often are slower to adopt new technology, it is not they themselves who are hesitant to use telehealth, but rather clinicians who worry that telehealth visits are insufficient to address more complex medical needs, McKnight’s Long-Term Care News reported last year.
