Because of the expansion of telehealth services through the 2020 Coronavirus Aid, Relief, and Economic Security (CARES) Act, there is growing potential for the use of telemedicine in the field of plastic surgery. A new study identifies populations that may have limited access to telemedicine and suggests measures that can be taken to reduce barriers to the wider adoption of telehealth.
A new study has found that demographic features such as rural living, low income, and being a member of unrepresented minority groups are key factors that potentially indicate low telemedicine literacy. This can limit patient access to plastic and reconstructive surgery and other healthcare services that can now be provided remotely thanks to the expansion of telehealth services.
The study, which appeared in the American Society of Plastic Surgeons’ journal Plastic and Reconstructive Surgery, found that patients in specific socioeconomically disadvantaged groups were less likely to have access to telehealth services. The authors suggest their findings could help target communities where interventions could help improve telehealth literacy and ultimately access to telehealth services.
Identifying Areas with a Low “Technology Literacy Index”
In the United States, the use of telemedicine has expanded significantly, driven largely by the need for social distancing following the COVID-19 pandemic. Since telemedicine is becoming increasingly accessible for both doctors and patients, it will likely also be used more frequently by plastic surgeons in the future, says Kavitha Ranganathan, an MD at Brigham and Women’s Hospital and Harvard Medical School, and senior author of the study. However, Dr. Ranganathan points out that barriers that limit access to telehealth visits may widen existing gaps that limit access to healthcare for disadvantaged socioeconomic groups.
The study aimed to identify population groups who may have limited access to telemedicine. The researchers analyzed a 2019 survey on the use of the internet and technology conducted by the Pew Research Institute to develop a new Technology Literacy Index (TLI), based on three factors: access to the internet, access to a smartphone, and comfort using technology. The Technology Literacy Index and the factors that limit access to telehealth were then compared with US Census data from 2018. This enabled the researchers to classify telehealth literacy as low, medium, or high for populations in counties across America.
Several elements were linked with telehealth literacy, including age, sex, race, employment status, income level, marital status, educational attainment, and urban or rural classification. The researchers found that telehealth literacy was more likely to be low among widows and widowers, those with low educational attainment (some high school or some college), those over 65 years of age, those with a disability, or those of Black or African American descent. Telehealth literacy was more likely to be high in populations with a greater percentage of advanced degrees and higher median earnings.
America by the Numbers
When the data was extrapolated to US populations, the researchers found telehealth literacy levels varied widely throughout the country. Counties with low telehealth literacy had a lower median annual income ($43,613 compared to $60,418) and a smaller share people had a college degree (16.7 percent versus 26 percent). Telehealth literacy was three times more likely to be low in rural populations compared to populations living in urban areas. Black communities were also identified as being more likely to have low telehealth literacy (78 percent compared to 49 percent for communities that had the lowest percentage of Black residents).
The researchers found that social factors are the largest barriers to telehealth access, with poor digital literacy being a major contributing factor. This has led to a decline in visits to providers since the start of COVID-19. The disparities limiting telehealth access can enable providers to identify at-risk populations who may require plastic or reconstructive surgery but not be able to access it, the authors suggest. The authors encourage medical insurance providers, healthcare providers, and policymakers to implement intervention measures to help improve telehealth literacy and access to telehealth care services within these communities. Doing so could help narrow the disparities in healthcare access method experienced by members of vulnerable communities.
Technological Innovation Can Improve Access to Telehealth Services
Wolters Kluwer, which publishes the journal in which the study appeared, provides a wide range of technological and software solutions to the healthcare industry. It aims to facilitate effective decision-making and improved outcomes across the healthcare system via technological innovations that support research and learning, as well as telemedicine and telehealth services. Innovative technological resources such as these can help improve telehealth literacy and access, and ultimately broaden the use of telehealth in a wide range of medical fields, including plastic surgery.