It’s now universally understood that the health of any given individual is based largely on factors outside of the clinical setting, such as where they live or their access to transportation. And, although telehealth can help address these social disparities by allowing for greater access to care, it can also present its own obstacle for some folks. With that in mind, here are a few tips for organizations wondering how to promote health equity in telehealth services like remote patient monitoring (RPM).

What is health equity, and why does it matter?

At a basic level, health equity is just what it sounds like — the concept that everyone has equal access to quality healthcare. It’s “the opportunity for everyone to receive the health care they need and deserve, regardless of social or economic status,” as the United States Department of Health and Human Services (HHS) explains on its Telehealth page.

That may sound like a commonsense goal, but it’s also a challenging one. In the U.S. alone, a number of long-standing social and economic conditions are known to work against universal health equity. Called social disparities of health, or SDoH, these are the “non-medical factors that influence health outcomes,” as defined by the World Health Organization (WHO).

“Research shows that the social determinants can be more important than health care or lifestyle choices in influencing health,” the WHO adds, noting that SDoH can account “for between 30-55% of health outcomes.”

Often, SDoH represents lack of access — for instance, those who can’t afford a specific surgery, or who don’t have the means to travel to a clinic or a rehab facility for regular therapy. But other social determinants can affect health equity in less obvious ways. Cultural biases towards immigrant, African American, LGBTQ+ and other communities can restrict access to care, for example. And the stress resulting from these denials can put people at even higher risk of chronic disease.

Because of the impact not just medically and emotionally on Americans, but also the financial impact they represent, social determinants have become a priority for U.S. healthcare organizations like the HHS and Centers for Medicare & Medicaid Services (CMS). Today, the question of how to promote health equity is being answered with efforts to expand access among a wide variety of communities and individuals

What can healthcare providers do to promote health equity?

Addressing The surge in the use of telehealth and remote care in recent years has largely helped the cause of health equity by spreading access to places that didn’t use to have it — for instance, by connecting someone in a rural community to a specialist in a city, thanks to intuitive, at-home medical devices designed for easy use and connectivity. Today, experts agree that telehealth “can help address disparities in access to healthcare services and health outcomes,” as the Agency for Healthcare Research and Quality (AHRQ) states on its website.

“Telehealth has the potential to become an important tool to address longstanding health inequities in the historically marginalized racial and ethnic groups that have been disproportionately affected by the COVID-19 pandemic,” agrees Tanya Albert Henry for the American Medical Association (AMA).

Yet telehealth can also represent its own social disparity. Indeed, limited access to telecommunications (also known as digital poverty) is itself frequently cited as a SDoH. Some of the most common barriers to equity in telehealth include lack of Internet connectivity and access to video communication technology (like a computer or smartphone), and/or the space to use it. And, as with standard care, language barriers can also be an issue, particularly among those who may already struggle with digital literacy.

For example, as the University of Chicago shifted to virtual care during the Covid-19 pandemic, it documented which patients opted for video visits and which used telephone calls. According to a Health Affairs summary, it found that “patients who were unhoused, had lower socioeconomic status, lived in rural areas, or were non-native English speakers were among those at highest risk of being unable to complete video visits.”

How to promote health equity within RPM programs

With these risks in mind, then, what steps can healthcare organizations take to promote health equity in the RPM programs they offer?

Consider health equity in pre-implementation setup

It’s important to focus on health equity from the very beginning of the process. Leading RPM solutions providers will work with you to customize solutions that meet your specific operational needs. And that process should include a mechanism to gain a clear understanding of health equity in the patients you serve, as well as an action plan of how to address it.

This could involve the use of intake forms asking program participants about their level of access and their preferences when it comes to technology use. Doing so could help determine which patients prefer communicating via phone, for instance, and which are more comfortable with a videoconferencing app. This is also the time to determine who needs additional assistive devices or other special considerations.

Work to ensure accessibility in program design

“Telehealth practitioners, professionals and system designers … need to purposely design for equity as part of achieving broader health system goals,” advise the authors of a 2022 paper published in the Yearbook of Medical Informatics.

This means doing everything possible to accommodate all needs within the RPM program design, including the materials provided to program participants. Try to make sure that you’re offering different formats and languages; focus on basic language and even image-based communications if possible, to engage people of all reading levels. And consider supporting digital programs with printed brochures to help ensure universal understanding.

Develop awareness and skills among clinical staff

Nurturing specific skills among the workers who actually deliver care can help organizations ensure that everyone has equal access and opportunities for engagement. Fluency with multiple languages and community connections can be helpful here, as can experience in education and cultural sensitivity and/or competency. Gaining these skills could mean hiring new workers, or helping connect current staff with educational opportunities.

“Plan time for staff and provider training,” advises the HHS, including “areas such as cultural sensitivity and accessibility requirements. Allow additional time to implement this training. Consider a dedicated telehealth support team or staff member. This might mean shifting staff roles or hiring additional employees. Having telehealth support will help more patients successfully participate in virtual visits.”

Support access and digital literacy within the community

Basic access and digital literacy and usually the most direct factors affecting health equity in any given area. Organizations can help meet these challenges by working directly with patients, such as arranging transportation or helping purchase equipment. In addition, they can get involved in their communities with special programs designed to develop digital literacy and telehealth awareness.

This may be classified as charitable giving, and can present an opportunity to promote services among the communities you serve. Organizations that have the resources to do so may also want to consider engaging in partnerships with academic institutions or technology providers.

Did you know? Funding opportunities are available to help some organizations setup RPM programs, particularly those that treat underserved populations. Learn more about RPM funding here.

Measure and improve with ongoing analysis

Keeping track of the satisfaction rates of program participants can help you understand how well all of these efforts are working, and what you can do to improve them. It’s also a good way to keep them engaged with what’s happening, and to give them an incentive to participate, knowing that their feedback isn’t just appreciated and listened to, but actually used to improve the program.

So, make sure that the data and analytics you track as part of your patient health management makes note of any relevant social disparities of health or other special needs. Doing so can help you make sure each person is addressed, and give you insights over time into whether you’re helping promote health equity in the RPM solutions you offer.

Get more insights into how to promote health equity with CareSimple

As a leading provider of RPM solutions, CareSimple specializes in helping healthcare organizations leverage technology to meet a variety of patient care needs. If you’re interested in learning more about how we can help you address health equity in your telehealth offerings, we’re standing by to help. Learn more by scheduling a free demo today.

And if you’re looking for a complete guide to remote patient monitoring, don’t miss our Ultimate Guide to RPM, offering everything from basic definitions to detailed looks at cost payment models and more.