Strategies for Digital Care of Vulnerable Patients in a COVID-19 World—Keeping in Touch

Abstract

The COVID-19 pandemic has catalyzed a seismic shift in health care delivery. Health care systems and physician offices have accelerated digital health solutions at record speed, putting telehealth at center stage as a critical strategy to flatten the COVID-19 curve. Telehealth has moved from being an optional service to an essential one.Author affiliations and article information are listed at the end of this article.

Inequities in neurology amplified by the COVID-19 pandemic

“…The small number of study participants who identified as African American, Asian, American Indian, Alaska Native, Native Hawaiian or Pacific Islander also reported greater difficulties in obtaining medications than participants who identified as white. These findings suggest that the effect of the COVID-19 pandemic on people living with neurological conditions is greater for already marginalized and underserved groups, and highlight existing structural barriers to health care, for example, the digital divide, which limits the ability of patients to attend telemedicine appointments and communicate via patient portals 9 . These publications indicate that the COVID-19 pandemic is a particular burden for Black, Latino and lower-income populations.…”

Equipping community health workers with digital tools for pandemic response in LMICs

“…This is especially needed in the face of infectious disease outbreaks when there are huge shortages of healthcare professionals and the immense psychological and emotional burden on healthcare providers. As the number of Covid-19 cases in LMICs continues to rise, the global health community is debating on what roles CHWs could and should play in the prevention, detection, and management of Covid-19 cases [ 3 ]. To create awareness among communities about Covid-19, CHWs serve as a trusted communicator to give culturally appropriate information on hand hygiene, sanitation, and social distancing.…”

“…A few CHWs are apprehensive of becoming vectors of spreading COVID-19 in communities. Lack of personal protective equipment (PPE) has also restricted many CHWs to reach out to families in need [ 3 ]. In some LMICs, CHWs have received guidelines from the health system to either stay home, stop working, and cease providing essential health-care services to their communities.…”

Can you hear me now?: Improving palliative care access through telehealth

“…Third, and possibly the most regularly cited, is the disruptions created by technological difficulties (e.g., glitches with video, sound, or internet connectivity) which can lead to frustrating clinical encounters. Fourth, cultural or language barriers are especially problematic, and this could lead to enhanced disparities that already have created inequities in health care (Gray et al, 2020). Fifth, technology fatigue and possibly burnout with telehealth visits by both clinicians and patients who may prefer the ritual of the office visit and the opportunity to have human contact and touch (Chwistek, 2020).…”

“…Another key consideration is the limited access and utilization of technology that affect LMIC and rural areas (Gray et al, 2020). With the expansion of broadband access and services, it is imperative that states implement legal, practical, and strategic plans to provide PC via telehealth for everyone everywhere (Bakitas, Allen Watts, et al, 2020), especially in underserved rural areas where there are existing healthcare disparities (Gray et al, 2020). As the telehealth field grows, we must continue to monitor potential disparities among underserved groups, to ensure all groups have equal access to this service.…”