It was announced on February 14, 2022, that the United States Department of Health and Human Services (HHS) has awarded nearly $55 million to 29 Health Resources and Services Administration (HRSA) funded health centres to increase healthcare accessibility through virtual care, like telehealth. This is aimed at helping underserved populations gain more access to and receive better quality healthcare.

Telehealth existed prior to the COVID-19 pandemic and one advantage of it is to help provide healthcare to individuals living in rural areas. According to the Harvard Health Publishing, as of 2020, 76% of hospitals in the US utilize telehealth to provider care.

With the pandemic and the advancements in technology, telehealth services have become even more commonplace today. However, in underserved communities, including but not limited to rural areas, there may be some barriers to telehealth.

The HHS states that some of these underserved communities can include low-income Americans, rural Americans, people of color, older patients, people with limited English knowledge, people who are underinsured or uninsured, etc. You can view the full list here.

Telehealth Challenges in Underserved Communities

Although telehealth doesn’t necessarily need to be conducted through video or the internet, at times there is still a need for this type of telehealth and if patients do not have access to internet or have a bad internet connection, then this could be an issue. In addition, not all patients have the equipment needed for all types of virtual visits. For example, video appointments may need access to a computer with a video camera or a smartphone, which may not be available to all.

Another issue could be a lack of private space in the home for these telehealth visits. One factor of telehealth, to ensure that the appointments are kept private, is being able to find a space so patients can have a one-on-one with the provider and keep the appointment as private as possible. For some patients it may be difficult to find this space.

For members of the community with disabilities as well as those who lack digital proficiency, it may be difficult to access the technology needed for telehealth appointments. Patients who use sign language may need to have video appointments or other technologies which may mean needing access to internet and a smartphone/computer. Besides technology, certain patients may need their caregivers during the appointment.

How to Overcome These Challenges?

Provide patients with ample information on telehealth visits to answer their questions and concerns. Help patients become aware of how telehealth visits will be conducted at your clinic or healthcare facility. What sorts of technology will you use? What sorts of technology will patients need? How will appointments be conducted for patients with disabilities? Give your patients enough information so they feel comfortable going into such an appointment for the first time. Additionally, information can be given not only to patients but to your providers and staff on how to conduct telehealth care and handle different situations. Patients’ guardians or caregivers can also be given information on what to expect.

As well, providers can write instructions for patients and give different telehealth options for patients who need more help with technology. If a video appointment is needed, providers can give instructions beforehand, and according to the HHS, also allow some more time, for the patient to figure out how to join the appointment. The HHS says in some cases a family member or caregiver may be needed to help the patient.

In terms of privacy concerns, discuss with your patients the importance of privacy and how to find a private spot for their appointments. This could be somewhere in their home, car, etc. Make sure they understand the criteria for the space needed. It might also help to offer other communication platforms like emails or secure messaging to increase the options available. Here are some resources for helping patients get ready for their telehealth appointments.

The HHS also has an entire page on how to conduct telehealth appointments with older patients. The resource can be found here. It mentions different practices that can be implemented to help these patients with telehealth visits, such as, providing more non-video options such as calls or emails. Having some non-video options can also help individuals who may not have access to a webcam/smartphone or good internet connection.

All in all, telehealth appointments has its advantages, but providers and staff will need to find and implement ways to solve these problems for the underserved communities. The HHS Telehealth website has additional resources providers can access to help patients navigate through telehealth in today’s environment. Having more options can help more patients get access to your healthcare facility’s telehealth services.