The Key to Telehealth’s Future is Widespread Accessibility 

A virtual doctor’s visit may have seemed far-fetched years ago, but by 2021, many patients have embraced telehealth as their preferred form of care. With increased digital transformation, living rooms could be the new waiting rooms. 

According to research conducted by healthcare technology and services company athenahealth, telehealth adoption skyrocketed in response to the COVID-19 pandemic—growing from under 1 percent of baseline visits on the athenahealth network pre-pandemic to 17% by April 2020. The de-identified data collected from across athenahealth’s network of customers also found that healthcare organizations’ adoption of virtual care revealed increased convenience for patients, expanding appointments outside of standard clinic hours and eliminating travel time. 

And while this shift has improved access to care for many, including chronically ill patients who require more frequent check-ins, it has also introduced some issues. After all, digital literacy is imperative to properly navigating the virtual waiting room, not to mention the necessity of a clear cellular or Internet connection. Without the proper interventions, it’s possible that a large subset of the patient population will be left behind in a new telehealth-first world.

Technology Opportunities to Expand Telehealth Access 

One area of immediate focus to ensure telehealth is accessible for all, instead of most, is Internet access. What may seem like a simple necessity requires innovation, beginning with an accurate understanding of who is currently offline. 

As recently as 2018, the FCC reported that 44 million U.S. households (about 40 percent of the population) did not have standard broadband connections due to lack of access or affordability. While telehealth frequently takes place via mobile devices, reliability to support key telehealth functions, including quality video streaming, remains an issue when you’re limited to cellular data. After an $80 billion investment from the broadband industry in network infrastructure that year, fiber broadband became available to roughly 6.5 million additional homes—the largest annual increase to date. But to get this information, the FCC has historically relied on Internet service providers (ISPs) to self-report access to develop coverage maps, making accuracy questionable. 

This spring, the FCC launched its first ever consumer-driven effort to improve broadband mapping data, recognizing broadband access is critical for everyone now that many services, including healthcare activities have moved online. With the FCC Speed Test app, individuals can test performance of mobile and in-home broadband networks, which will then be collected to drive improved coverage information to the public. Improved data accuracy will allow broadband funding programs to target communities most in need, like those in rural areas, where only 11 percent of patients were likely to have a virtual visit compared to 17 percent of patients in urban areas, based on analysis of de-identified data from across athenahealth’s network of healthcare customers. 

And in response to the increase in telehealth visits and the need for more ubiquitous access, some states and counties are getting creative when it comes to Internet access—even moving beyond broadband. One county in Wisconsin recently announced it will pilot the viability of satellites to expand Internet access in rural areas. This initiative was driven by a 461 percent uptick in telehealth visits within a state-wide clinic during the pandemic. Communities in Ohio and North Carolina are following suit, noting that the low-orbit satellite technology would be more affordable compared to running traditional, broadband Internet cables.

Connectivity Goes Beyond the Internet 

The Internet is just one way to ensure access, though. Technological literacy is also a major hurdle for many patients. Everyday devices like phones, computers, tablets, and watches have the ability to track health data to contribute toward virtual care. But as common as the technology is, a significant population of Americans don’t know how to use it. According to one report, about 16 percent of American adults are not technologically literate (possessing the ability to safely and effectively utilize digital devices). 

For those who do have Internet or mobile access, a telehealth appointment could be the first time a patient downloads an app or participates in a video call, which introduces a learning curve healthcare organizations should be cognizant of if telehealth is going to reach larger populations.

“The key to managing the learning curve is to have a very small one and keep it simple,” says Paul Brient, SVP and Chief Product Officer at athenahealth. “That was one of our goals in launching a new telehealth product. If you can receive an SMS and click an embedded link, you can use athenaTelehealth^TM.”

And while some patients are willing to embrace new health technology through smart devices, others may have higher amounts of resistance due to data privacy concerns or reluctance to change—especially patients 60 and older who, according to athenahealth’s research, have been less likely to access telehealth than younger adults. Healthcare organizations can alleviate resistance by establishing trust with patients, demonstrating virtual care can be easy and is safe to use. In fact, the research shows that adoption is driven by the practices themselves—if a clinician works with a patient and suggests telehealth as a great option, patients are more likely to use it.

The more involved a provider is with onboarding, the less of a barrier for patients. For example, some providers on the athenahealth network even had front desk staff contact patients ahead of their virtual appointment to explain how the process works and what technology is required. Others hired patient navigators to help patients turn on video and navigate telehealth apps. 

How Improved Access Can Mean Improved Care 

Equipped with the resources and confidence to utilize telehealth technology, virtual care is a win-win for both the patient and provider. Telehealth offers patients an opportunity for increased points of connection with their providers, allowing for a fuller picture compared to in-office exams or lab results. More patient data allows doctors to intervene at earlier stages, make more informed diagnoses and care plans—all of which have the potential to improve outcomes. 

“Telehealth gives doctors more opportunities to connect with patients—especially patients with chronic conditions,” says Brient. “An extra 15-minute check-in here and there can mean the difference between catching the warning signs that allow an early intervention and having your patient end up in the emergency room before their next in-office appointment.”

Increased use-cases driven by the pandemic highlighted the opportunity for more patients to benefit from virtual care. The caveat, however, is a patient's ability to connect to and adequately use telehealth. Recent efforts to expand access through innovative technology and an intuitive experience could help bridge the digital divide Americans experience and narrow the gap in access to care.

This article was produced by WIRED Brand Lab on behalf of athenahealth.