Telehealth can expand health care only where patients have internet access

Telehealth has potential to expand health care access for patients in areas of the country with fewer physicians, clinicians, and hospitals.

Or, it would if those areas had high speed internet access.

A new study showed disparities in digital access might cancel out possible benefits of meeting physicians online. Across the country, rural and less densely populated areas that have fewer health care opportunities also have less capability for online services.

“The point is telehealth is not going to be useful to everybody,” author Diego Cuadros, PhD, said in a University of Cincinnati (UC) news report. “It will be extremely useful to people who already have good access to health care, but it's not going to be very useful to those who don't.”

Cuadros is a UC epidemiologist and coauthor Claudia Moreno, PhD, is an assistant professor of physiology and biophysics at the University of Washington. They presented the findings at the American Association of Geographers’ annual conference.

Studies have examined how telehealth boomed during the COVID-19 pandemic and the researchers believe physicians and patients will continue using online appointments.

“The pandemic was a tipping point for us,” Cuadros said. “These technologies are here to stay. That’s how we’ll experience a lot of aspects of our life, from education to relationships to health care.”

The United States is a global leader in telecommunications, but it also is geographically large. At least one survey found the nation does not rank in the top 20 around the world for per capita wireless coverage.

County-level data show there are swaths of the country, particularly in the South, but ranging from the Atlantic coast to Arizona, where less than 65% of the population has broadband coverage.

“What was surprising was to see the strong correlation between the lack of broadband access and the socioeconomic and health care vulnerability of some regions,” Moreno said in the UC news report. “This association suggests that broadband coverage can act as an institutionalized inequity that needs to be addressed to help vulnerable communities.”

Cuadros predicted an existing digital divide could become even larger. The researchers noted the administration of President Joe Biden announced it would invest $73 million in outreach grants for affordable high-speed internet access for more people. That program aims to narrow the access gap created during the pandemic when physicians and health care facilities expanded services online.

Not every patient has made that “same digital transition,” Moreno said.

“The reality is that not everyone was thrilled with that option,” she said. “Accessing telehealth is challenging for people that are not digitally literate or for people who do not own a smartphone or a computer.

“Telehealth has a huge potential to help vulnerable communities, but if we really want to exploit this potential, the country needs to create policies and programs that increase access within these communities,” Moreno said.