In recent years, telemedicine (TM) and other digital health solutions have emerged as powerful tools to improve access to healthcare services, particularly for underserved communities. While these technologies have the potential to transform the healthcare landscape, they also face significant challenges. In this post, we will explore the promise and examine the barriers that must be overcome to ensure equitable access to healthcare services.
Healthcare is relational, not transactional. A key challenge with current telemedicine is the episodic nature of its delivery. While video consults and ‘chat sessions’ can provide valuable support for patients needing a quick consult, they fail at delivering the continuity of care necessary for the long-term management of chronic conditions. Furthermore, most TM models do not look at the patient holistically, instead focusing on specific symptoms or conditions, resulting in fragmented care that fails to address the many factors that affect one’s health.
The Covid-19 pandemic resulted in an explosion of digital solutions that widened the digital divide. Instead of scaling evidence-based tools that had demonstrated success during non-pandemic times and were focused on equity and a patient-centered approach, governments invested in Apps and other technologies that required intense infrastructure such as reliable Internet, data, and Smartphones which left underserved communities and the most vulnerable behind. Inequitable access to digital services meant that marginalized groups suffered disproportionately in an already fractured system.
To address these challenges, we need to invest in technologies that have been designed with a patient-centered and equity lens. This requires a community-driven approach that helps to identify the unique needs and challenges faced by underserved communities.
WelTel was designed from the ground up and proven to be effective through the world’s first randomized clinical trial to show improved adherence through the use of interactive, 2-way SMS-text messaging (The Lancet; Lester et al, Nov 2010). Engaging with diverse communities across the globe to understand health needs has contributed to the applicability and cultural safety with which WelTel has come to be known and respected. What is missing in most current Telemedicine models are convenient ways to communicate with known healthcare providers that support continuously connected care and pay homage to the relational nature of health.
Telemedicine does not replace in-person care. The best solutions are complementary and offer support to patients in need of acute care, while also providing continuity of care and long-term management of their chronic and ongoing health needs. Using a patient-centered communication approach that understands the importance of strengthening relationships to build trust has allowed WelTel to close the digital divide by enabling access to care that is truly equitable for all.