It is our shared responsibility to ensure equal access to quality telehealth care for everyone. We can do that through improvements to telehealth workflow, staff training, and community resources. We should also meet the needs of underserved populations in our communities.

Health equity in telehealth is the opportunity for everyone to receive the health care they need and deserve, regardless of social or economic status. Providing health equity in telehealth means making changes in digital literacy, technology, and analytics. This will help telehealth providers reach the underserved communities that need it the most.

Underserved communities often include:

• Low income Americans
• Rural Americans
• People of color
• Immigrants
• People who identify as LGBTQ
• People with disabilities
• Older patients
• People with limited knowledge of the English language
• People with limited digital literacy
• People who are underinsured or uninsured

Underserved communities often lack equal access to health care, leading to consequences such as:

• Higher mortality rates
• Higher rates of disease
• More disease and illness severity
• Higher medical costs
• Lack of access to treatment
• Lack of access to health insurance

Health care providers should incorporate methods into their practice to reach underserved patients and ensure equal access to necessary telehealth care.

Barriers to telehealth access may include:

• Lack of video sharing technology, such as a smartphone, tablet, or computer
• Spotty or no internet access
• Lack of housing or private space to participate in virtual visits
• Few local providers who offer telehealth practices
• Language barriers, including oral, written, and signed language
• Lack of adaptive equipment for people with disabilities

There are many ways to improve access to telehealth. This will help new patients feel welcome and comfortable.

• Make materials accessible in different formats and multiple languages.
• Use images and words in your online communications for patients with low literacy.
• Measure patient satisfaction with post-visit surveys to improve service. Knowing what your patients need will help them feel more comfortable with virtual visits.
• Use inclusive patient intake forms that ask about access to technology and patient preferences. This could include language and pronoun preferences.
• Ask if your patients need assistive devices to participate in virtual visits.
• Encourage staff to learn how to broaden telehealth access. Consider sending internal news and progress related to accessibility.
• Include accessibility options within your telehealth programs. This could include screen readers or closed captioning options.
• Allow extra time in virtual visit appointments for patients that may need support in getting online.
• Use technology designed with equity in mind when it comes to speech recognition and health prediction algorithms.
• Encourage all patients to get involved in planning and implementing health equity. This could include:
  • Sitting on a board or committee
  • Providing input on materials or procedures
  • Conducting sensitivity training
• Look for skills and experiences within your team, including:
  • Cultural competency
  • Connections to the local community
  • Experience working with underserved patient groups
  • Fluency in languages other than English