Health equity through telehealth

A critical factor in healthcare access is the availability of healthcare professionals. The WHO estimates a shortage of 18 million health workers by 2030, predominantly in low- and lower-middle-income countries.

Non-communicable diseases (NCDs) such as heart disease, stroke, and diabetes are the leading cause of mortality worldwide, accounting for 71% of all deaths globally, according to the WHO. Access to preventive and treatment services for these conditions is significantly lower in low-income countries.

As per UNICEF, the probability of a woman in a low-income country dying from a maternal-related cause is about 1 in 45, compared to about 1 in 5,400 in high-income countries. Additionally, children in low-income countries are more than ten times more likely to die before the age of five than children in high-income countries.

How telehealth promotes healthcare equity?

• Enhancing accessibility: One of the most significant advantages of telehealth is its ability to make healthcare services accessible to people in remote or underserved areas.
• Cost-effectiveness: Telehealth can be more affordable for both patients and healthcare providers. It reduces the need for expensive infrastructure and overhead costs associated with traditional in-person clinic visits. It can mean lower travel costs and time savings for patients, making healthcare more accessible, especially for those with limited financial resources.
• Cultural and linguistic inclusivity: Telehealth platforms can offer services in multiple languages and accommodate cultural sensitivities, bridging the gap for non-English speakers and diverse cultural groups.
• Chronic disease management: Chronic diseases often require ongoing management and monitoring, which can be challenging for patients living in areas with limited healthcare resources. Telehealth enables regular and convenient monitoring and consultation for these patients.
• Mental health services: Telehealth has proven particularly effective in providing mental health services, often neglected in traditional healthcare systems. It offers a level of anonymity and convenience that encourages more people to seek help for mental health issues, reducing the stigma and logistical barriers associated with these services.
• Education and prevention: Telehealth platforms can be used for patient education and preventive care, critical aspects of public health. Through telehealth, patients can access educational resources and participate in preventive programs, which are especially beneficial in communities with limited access to health information and services.

Case studies and success stories

To illustrate the impact of telehealth in promoting healthcare equity, it's essential to look at real-life examples and success stories. These case studies highlight how telehealth has effectively bridged gaps in healthcare access and quality.

• Rural healthcare access: In remote areas of Alaska, where many communities are only accessible by plane or boat, telehealth has revolutionized healthcare delivery. The Alaska Native Tribal Health Consortium (ANTHC) has implemented a telehealth system that connects remote villages with specialists in urban centers. This system has significantly improved Alaska Natives' access to healthcare, reducing the need for expensive and time-consuming travel.
• Mental health services in underserved communities: In regions where mental health professionals are scarce, telehealth has provided an invaluable service. For instance, a program in rural Australia uses telehealth to connect patients with mental health specialists in urban areas. This approach has helped reduce the stigma of seeking mental health care and made services more accessible in these communities.
• Managing chronic diseases in low-income populations: A clinic in a low-income neighborhood in the United States implemented a telehealth program for diabetic patients. The program provided remote monitoring and regular virtual consultations with healthcare providers. This led to a significant improvement in blood sugar control among participating patients, demonstrating the effectiveness of telehealth in chronic disease management in underserved populations.
• Telehealth in response to COVID-19: The COVID-19 pandemic forced many countries to adopt telehealth services rapidly. In Italy, one of the hardest-hit countries, telehealth was used extensively to monitor COVID-19 patients at home, freeing up hospital beds for more severe cases. This improved care for COVID-19 patients and ensured the continued delivery of healthcare services to non-COVID patients.
• Language and cultural barriers: A telehealth service in California offers consultations in over 15 languages, addressing the needs of a diverse patient population. This service has been particularly beneficial for non-English speaking immigrants, who often face language barriers in accessing healthcare.
• Educational programs for preventive health: In some African countries, telehealth initiatives have focused on education and prevention. Mobile health applications provide information and alerts about infectious diseases like malaria and tuberculosis, helping to increase awareness and prevent outbreaks.

Future perspectives

• Technological innovations: The future will likely see more advanced telehealth technologies, including the integration of artificial intelligence (AI) for diagnostic support, the use of big data for personalized care, and the expansion of virtual reality (VR) for therapeutic purposes.
• Policy and regulation: As telehealth becomes more ingrained in healthcare systems, there will be a greater need for comprehensive policies and regulations that address issues like reimbursement, privacy, and cross-border services. Effective policy-making will ensure that telehealth services are accessible and affordable and maintain high-quality standards.
• Public and private sector collaboration: The future of telehealth will be shaped by collaborations between governments, healthcare providers, technology companies, and other stakeholders.
• Training and education for healthcare providers: As telehealth becomes more prevalent, healthcare professionals will need additional training to deliver remote care effectively. This includes technical training and developing skills in remote patient engagement and cultural competency.
• Patient-centered approaches: The future of telehealth will likely see a greater emphasis on patient-centered care. This involves designing telehealth services that are not only technically efficient but also responsive to the unique needs and preferences of different patient populations.
• Global health equity initiatives: International collaborations and knowledge sharing will be vital in implementing telehealth solutions that can be adapted to various cultural and economic contexts.
• Sustainability and resilience in healthcare: The ongoing challenges posed by global health crises like the COVID-19 pandemic underscore the need for resilient healthcare systems. Telehealth will be instrumental in building healthcare systems that are more resilient to emergencies and sustainable in the long term.