Telehealth expansion and health disparities: 3 leaders weigh in

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The COVID-19 pandemic is placing a large spotlight on many disparities that have plagued the U.S. healthcare system for years. At the same time, the pandemic also has accelerated the adoption of telemedicine, which may offer patients more access to care and convenience.

Three leaders discussed key opportunities and challenges associated with using telehealth to address health disparities during a Nov. 3 session of the Becker's Healthcare Telehealth Virtual Forum. Panelists included:

  • Laishy Williams-Carlson, CIO of Bon Secours Mercy Health in Cincinnati
  • Staci Lucius, president of medical group and physician services at Bon Secours Mercy Health
  • Tom Brazelton, MD, medical director of telehealth at UW Health in Madison, Wis.

Here is an excerpt from the conversation, edited for clarity. To view the full session on-demand, click here.

Question: What are some key "dos and don'ts" of telehealth expansion for healthcare organizations looking to reduce health disparities?

Laishy Williams-Carlson: From a technology perspective, I would say one "don't" is don't reinvent the wheel. For example, we reached out to community health colleagues in the system to look for touchpoints in the communities we serve, rather than reinventing the wheel. One of our communities has a large population of brown and black people, so we worked to identify the go-to, trusted locations for that population, especially people who may not be a "digital native." For an older black person, a trusted entity in their community might be the church. So, we've started talking to church leaders in this community. How can we set up telemedicine programs where we are assuring the church has high-speed availability and potentially resources there that can help folks who are non-digital natives navigate a virtual visit for the first time and become comfortable with it? Rather than thinking independently — 'where can we set up locations that folks could come to if they don't have broadband access?' — approach it as 'what is already there that we can plug into and add value?'

Staci Lucius: Another "do" in my mind is really understanding the disparity between people who live in urban versus rural locations. I read a statistic recently that said 81 million people in the United States are living in an area with a shortage of primary care professionals. When you think about our population being just north of 330 million, that's a significant part of our population that may have basic access issues to even primary care, much less specialists. So I think along the lines of what Laishy shared, there's a tremendous opportunity for health systems to think about how we can partner with community partners or even with primary care providers in our more rural areas to bring access to areas of specialty that they may not otherwise have.

Dr. Tom Brazelton: We have a new chief officer of diversity, equity and inclusion, and I know she's working hard to set up those community connections. Other 'dos' I'd add are listen to your champions — those rare, early adopters, innovators, or whatever the term will be moving forward. And don't do it from a top-down perspective. If you've seen one telemedicine or telehealth program, you've seen one telemedicine program, but the ones that don't seem to work are when the executive leaders have said, 'We have to do this,' and then it is imposed in certain ways that the providers have to do it. There are a lot of champions within any organization, and ones with great ideas. And oftentimes, it's starting with them. 

Also, do have really good project management. I have nothing but respect for our project managers who take these on and keep these projects alive and moving. Without them, there's no way we could've gotten through what COVID-19 brought on, but it's also helped us move very quickly on toward the context of us linking with Epic and some other things, because we know we need to continue to move quickly. So, do have good leadership, but don't be too autocratic in that regard.

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