The COVID-19 pandemic accelerated the adoption of telehealth, a growing trend that offers a solution for delivering healthcare efficiently and safely within the comfort of one’s home. Telehealth has emerged as a transformative tool, reducing the need for travel and long wait times, particularly benefiting those with limited access to traditional healthcare. However, despite its advantages, telehealth faces limitations that significantly impact the Black community.
Dr. Neil Calman, CEO of the Institute for Family Health, highlights that technology can be both an equalizer and a discriminator. While telehealth can improve access to healthcare, it also exacerbates disparities for those without access to necessary technology. The Institute for Family Health, serving medically underserved communities in New York City, emphasizes the need for equitable access to remote healthcare.
Studies have highlighted racial disparities in telehealth access. A study from the JCO Oncology Practice medical journal found significant differences in telehealth use among cancer patients at East Carolina University Health System. While 43% of in-person visits were with Black patients, only 29% of telehealth visits involved Black patients, indicating barriers in digital access. Similarly, a study from the Journal of the American Medical Informatics Association found that Black patients were more likely to use emergency rooms than telehealth for COVID-related care, highlighting issues like digital literacy and telehealth awareness.
Evans Rochaste, founder of ReKlame Health, underscores that systemic discrimination, such as the Tuskegee experiment and high Black maternal mortality rates, contributes to distrust and stigma in healthcare. ReKlame Health addresses these biases by providing culturally competent psychiatric care through telehealth. Empathy and understanding are central to their services, facilitating effective relationships between providers and patients.
At New York-Presbyterian Hospital, the Community for Tele-Paramedicine program extends remote healthcare to vulnerable populations. The program includes home visits and guidance on using telehealth technology, focusing on communities most affected by social determinants of health. Dr. Brock Daniels, Medical Director of Community Tele-Paramedicine, notes that these efforts help circumvent barriers and deliver essential care.
Telehealth offers convenience, particularly for behavioral health services. Dr. Calman points out that telehealth allows patients in entry-level jobs to access care without missing work. Zayin Tilley, a telehealth user, found that virtual therapy sessions provided crucial support during a stressful internship, demonstrating telehealth’s potential to offer timely mental health assistance.
However, telehealth is not without its challenges. Tilley mentions that the lack of physical presence can make care feel superficial, affecting the quality of mental health services. Additionally, the U.S. Census Bureau reported that over one million homes in New York lacked broadband internet access in 2019, with Black households having the highest rate of no broadband access. This digital divide makes telehealth inaccessible for many, perpetuating healthcare disparities.
Ensuring equitable implementation of telehealth and other technologies is crucial. Rochaste emphasizes the importance of ethical application of advancements like artificial intelligence, considering cultural nuances and diverse backgrounds. Innovators must remain vigilant to avoid exacerbating disparities while advancing groundbreaking technologies.
Telehealth has the potential to revolutionize healthcare, but addressing its limitations and ensuring equitable access are essential for it to benefit all communities, particularly those historically underserved. By focusing on empathy, cultural competence, and systemic improvements, organizations like ReKlame Health, the Institute for Family Health, and New York-Presbyterian Hospital strive to make telehealth a viable and inclusive option for Black communities.
