Telehealth in its myriad forms did not begin with the COVID-19 pandemic, nor will it end with it. But the pandemic engendered a surge in telehealth use that was not only unprecedented but which has helped to instigate a significant shift in the practice of medicine. What was once a rather fringe element of healthcare, widely considered secondary, and perhaps even inferior, to traditional in-person care has now become the healthcare strategy of choice for millions of patients and practitioners alike.
That does not mean, however, that all patient populations feel equally at home in the virtual clinic. There are steps that practitioners and technologists can take, though, to make telehealth more open and welcoming to all.
The Importance of Empathy
Medicine is truly the ultimate caring profession, and empathy should always lie at the heart of healthcare practice. Unfortunately, for clinicians who may not be accustomed to providing remote care, empathy may be more difficult to demonstrate in the digital domain than it is at the patient’s bedside.
And this can be particularly true when healthcare providers are remotely tending to patients who hail from cultural or linguistic backgrounds different from their own. Making the telehealth environment more welcoming to a diverse patient population, then, must involve a commitment to the practice of intercultural empathy, the effort to understand and demonstrate respect for the patient’s unique background and the impact this may have on the patient’s needs, expectations, behaviors, and health practices.
As a component of showing intercultural empathy, the telehealthcare provider should work to anticipate and address the patient’s unique care needs. For example, a clinician may recruit an interpreter or even integrate software into the telemedicine platform that enables interpretation and ensures ease of communication with patients from diverse language backgrounds.
Even for patients who derive from the same cultural and linguistic background as their healthcare provider, there can still be unique needs that care providers can only recognize and address by practicing empathy. And this means that sometimes telehealth patients will need more specialized care than a general practitioner can provide.
Mental Health Nurse Practitioners, for instance, are uniquely qualified to meet the social and psychological needs of patients through empathetic practice. To create an open and welcoming telehealth environment, patients must be made aware of and have access to the plethora of mental health services available through telemedicine, including the immensely beneficial services that nurse practitioners specializing in mental healthcare can provide.
One of the most significant impacts of the pandemic is that it has made telehealth services available to the majority of patients on Medicare and Medicaid. However, with the expansion of telehealth coverage has come increasing demand for virtual healthcare by patient populations that have traditionally been marginalized and underserved, including the elderly, the disabled, and the poor.
These patient populations are likely to have very different and far more significant healthcare needs than the general population, a reality that technologists and telehealthcare providers alike must be prepared for.
For instance, patients on Medicare and Medicaid are almost inevitably living on limited and fixed incomes. And this means that they may not be able to afford access to reliable, secure, high-speed internet. Making the virtual clinic more open and welcoming, then, must necessarily mean resisting the automatic assumption that all telehealth patients will be able to access an internet connection strong and reliable enough for a smooth remote consultation.
Thus, healthcare providers will need to be particularly sensitive to the challenges that some telehealth patients may face, ready to be flexible and improvise when the need arises. For instance, a planned video conference may need to be abandoned for a landline phone call when patients in rural areas or those with low incomes can’t access the internet.
Such agility in the provision of remote care, such as a willingness to accommodate the unique and evolving needs of telehealth patients, is integral to creating a welcoming environment. It reduces the stigmatization that too many people face in being among the 21 million Americans without reliable access to the internet.
Telehealth may well be the future of medicine. In the wake of the COVID-19 pandemic, in particular, telehealth has demonstrated its tremendous capacity to increase access to consistent, high-quality healthcare for once underserved and marginalized patient populations. Despite the enormous potential of telehealth, however, not all patients feel equally welcome. Barriers related to income, internet access, cultural and linguistic differences, and inadequate mental healthcare can make the telehealth space feel less than open and welcoming. With effort, understanding, and strategy, though, telehealth can truly become the space of inclusivity and equity that it should be. It begins with the practice of empathy and ends with the provision of patient-centered accommodations, including healthcare providers’ willingness to be flexible in meeting patients’ evolving and unique needs.