Since the COVID-19 global pandemic, telemedicine has become an important part of the healthcare industry, offering patients access to many medical services through various technologies. Telemedicine has provided people living in rural or underserved urban communities with the opportunity to receive adequate care without the issues of long travel distances and expenses. It has proven beneficial for “managing chronic conditions, where regular monitoring and timely interventions are crucial” (Campos-Castillo & Anthony, 2020). However, marginalized populations in rural and urban areas are unable to take advantage of these services due to challenges such as limited internet access and lack of education on proper telemedicine usage.
This healthcare option is crucial for marginalized communities because it provides accessible, high-quality healthcare services, overcoming barriers like transportation, financial limitations, and limited local medical resources. However, to increase the use of telemedicine, we must first examine the infrastructural changes needed for successful implementation.
Challenges To Telemedicine Access: Work Schedules
Both rural and urban populations face significant challenges in accessing healthcare, including geographic barriers, socioeconomic variables, and low-quality healthcare infrastructure. One may ask, “Why do these challenges exist?” Are there financial problems, a lack of health insurance coverage, transportation difficulties, or limited medical practices in their neighborhoods? Ng et al. (2024) cite data from a 2022 National Health Interview Survey that identifies “being too busy with work or other commitments to go to a provider” as the most widespread non-financial barrier cited (p. 6). What can we do to help?
Providing paid time off for medical appointments for employees is one solution Ng (2024). New York City’s Paid Safe and Sick Leave Law is an excellent model for other cities. It ensures individuals are granted a minimum number of hours to address their health needs or those of their family members. Initially, many employers were skeptical and assumed their employees would take advantage of the time allowance at a steep cost, however, that was not the case. In fact, over a year later, 86% of employers who were surveyed supported the sick leave program (Applebaum & Milkman, 2016).
Additionally, companies can consider partnering with a telehealth service so visits could occur during the workday, to reduce the number of sick hours needed. To implement an employee telehealth program, a company should partner with a reputable telehealth provider to offer virtual medical consultations and health resources, ensuring easy access for employees through a secure online platform. The company should promote awareness and provide training sessions to encourage usage, highlighting its benefits in reducing absences by allowing employees to conveniently address health concerns without needing to take time off.
Addressing Internet Access as a Key Barrier
Another barrier affecting the widespread use of telemedicine is the lack of internet access. Many rural and urban populations may not have reliable internet access or a device to access their online appointments. Politicians, specifically those in local government, should prioritize raising revenue in these areas, to provide affordable internet access and devices where needed. For example, The New York Office of Technology’s Program, Big Apple Connect, supplies high-speed internet access to over 200 housing complexes in NYC (NYC Big Apple Connect, n.d.).
It is more difficult to implement these types of programs in rural communities in New York, where only 31% of households do not have internet access (Examining Gaps in Digital Inclusion in New York, 2022), but there is hope. In Madison County, a rural area in upstate New York, officials are in the middle of a multi-million dollar project to bring their communities high-speed internet access. The project is funded by the USDA Rural Development ReConnect Grant which has allocated $1.6 billion across 31 states.
Educating Communities and Overcoming Language Barriers
Education is another key factor in expanding telemedicine access. Many individuals lack the knowledge to navigate telehealth platforms and devices. Offering training programs and resources, especially in multiple languages, can ensure that everyone has equal access and that a person’s language does not deter their access to quality healthcare.
Programs such as NYC Care provide free and low-cost health services to people who cannot afford health insurance. The program includes a 24/7 hotline which provides assistance in multiple languages, allowing the LEP population to navigate the healthcare system and gain access to a variety of programs, including telemedicine. Strengthening these types of programs and informing the LEP population of these resources will be necessary in furthering telemedicine accessibility.
Increasing telemedicine access is crucial for reaching underserved communities, particularly those in rural and urban communities. Despite some of the more common challenges, expanding telehealth services can ensure that more people receive timely, effective, and high-quality care. By investing in infrastructure and providing educational resources, we can bridge the gap and make healthcare accessible to underserved communities. Advocating for policies and initiatives that support the growth of telemedicine and improve healthcare access across marginalized populations is essential to win the fight for healthcare equity.
Work Cited
Big Apple Connect. (n.d.). https://www.nyc.gov/assets/bigappleconnect/
Anthony, D., & Campos-Castillo, C. (2020). Why Most of Your Patients Aren’t Using an Online Portal, and What You Can Do About It. Rhode Island Medical Journal (2013), 103(1), 32–34.
Applebaum, E., & Milkman, R. No big deal: The impact of New York City’s paid sick. (n.d.).
https://cepr.net/images/stories/reports/nyc-paid-sick-days-2016-09.pdf
Ng, A., Adjaye-Gbewonyo, D., & Dahlhamer, J. (2024). Sociodemographic Differences in Nonfinancial Access Barriers to Health Care Among Adults: United States, National Health Statistics Reports Number, 207. https://www.cdc.gov/nchs/data/nhsr/nhsr207.pdf.
Park, J. H., Lee, M. J., Tsai, M. H., Shih, H. J., & Chang, J. (2023). Rural, Regional, Racial
Disparities in Telemedicine Use During the COVID-19 Pandemic Among US Adults: 2021 National Health Interview Survey (NHIS). Patient preference and adherence, 17, 3477–3487. https://doi.org/10.2147/PPA.S439437.
Sheikh, Dr. H. (n.d.). Addressing health disparities through telemedicine. Multidisciplinary
Journal of Healthcare (MJH). https://www.researchcorridor.org/index.php/mjh/article/view/40.
Srinivasan, S., & Williams, S. D. (2014). Transitioning from health disparities to a health equity research agenda: the time is now. Public health reports (Washington, D.C. : 1974), 129
Suppl 2(Suppl 2), 71–76. https://doi.org/10.1177/00333549141291S213.
