Bridging the Digital Divide to Avoid Leaving the Most Vulnerable Behind

Abstract

The COVID-19 pandemic provided a springboard for telemedicine use as a necessity to deliver care while social distancing affected all aspects of health care. The declaration of a public health emergency in March 2020 resulted in a rapid expansion of telehealth services with a relaxing of regulations at the state and national levels. Nationally, there is mounting evidence that many aspects of patient care can continue virtually, 1 including a more prominent role across surgical disciplines in preoperative and postoperative care and management of chronic wounds. More widespread use of telemedicine and the ability to engage in new patient evaluations can help reduce geographic barriers and allow hospital systems to create capacity for patients with more severe illness to be seen in person, while patients who are stable and healthier can engage from home. Combining virtual and hands-on care will undoubtably persist beyond the pandemic.However, reliance on technology brings forth pressures that can widen the gap in access to care for vulnerable populations; the COVID-19 pandemic has undoubtedly redefined what it means to be vulnerable in society. A recent study of more than 600 000 Medicare beneficiaries dwelling in communities from the 2018 American Community Survey demonstrated that 26% did not have access to either a computer with highspeed internet or a smartphone with a wireless data plan. Among other factors, individuals who were older, Black or Hispanic, widowed, or lacking more than a high school education reported more limited digital access. 2 Furthermore, during this time, millions of individuals in the US are facing financial, emotional, and physical constraints that are unique and life changing. How can we move forward while not leaving the most vulnerable behind?

A Cross-Sectional Analysis of Factors Associated with Appointment Completion and Visit Modality during Virtual Urology Visits

“…With all of this in mind, further efforts to address the so-called "digital divide" can ensure that instead of propagating established disparities in care, telehealth applications can be leveraged to improve quality of care for all. 10 We would suggest such efforts should include more thorough pre-appointment planning and counseling with identified at-risk patients in order to facilitate appointments that will be easier for them to schedule and subsequently complete. Additionally, policy decisions should appreciate the limitations of disadvantaged communities.…”

“…8 Given the novelty of telehealth, multiple commentaries have recently called for further work analyzing patterns of care to better understand disparities in access or use of telehealth services. 9,10 In this context, our objective was to describe and analyze key characteristics of patients receiving virtual care within urology at a large academic institution servicing a diverse metropolitan area. We primarily sought to characterize which patients are more or less likely to complete a scheduled telehealth appointment based on various appointmentspecific and sociodemographic factors.…”

The impact of COVID-19 on children's lives in the United States: Amplified inequities and a just path to recovery

“…In addition, issues of privacy, safety and multilanguage interpretive services accentuate this gap. 75 …”

We’re not in Kansas anymore: Reimagining a new yellow brick road for treating youth and their families in the peri- and post-pandemic periods.

“…Several authors (Eruchalu et al, 2021; Eyrich et al, 2021) offered recommendations for narrowing the digital gap. Providing governmental subsidies for broadband accessibility, encouraging the development of Wi-Fi hot spots in libraries, schools, and community centers, increasing digital literacy through low/no cost educational programming at community colleges, as well as constructing culturally equitable virtual platforms are intriguing strategies (Eruchalu et al, 2021).…”