Although telemedicine has been around for years, the COVID-19 pandemic has certainly proliferated its use and brought about more innovative uses of telemedicine to provide optimal and safe care.
Telemedicine visits with a clinical pharmacist offer many benefits, such as social distancing, flexible hours, and the ability to use non-verbal cues to convey understanding, a major limitation of telephone visits. Telemedicine also has the ability to help narrow the current gaps in health disparities among various populations, including the most financially vulnerable.
However, certain phenomena such as digital health literacy must be taken into account. Digital health literacy is similar in concept to health literacy; that is, the ability of a patient to access and understand health information or services.1 Digital health literacy encompasses a number of skills, including computer literacy. So, if telemedicine is not properly organized, it can actually end up making health disparities worse.1
A recent cohort study examined 148,402 patients who had scheduled telemedicine visits.1 The study found that older age, Asian race, and a primary language other than English were associated with fewer completed telemedicine visits (both phone and video). Other studies have shown lower video use associated with lower family income, Latinx ethnicity, black race, and older age.2
The reasons for these results could be explained by lower digital health literacy. For older people, less frequent use of technology in general, impaired vision, and reduced hearing and motor skills make telemedicine a challenge.2 In addition, families with median household income less than $ 50,000 had a lower rate of video telemedicine use.2 These results can be attributed to the availability of Internet access or devices. COVID-19 has put additional financial pressure on low-income families, which could further widen the digital inequality gap between low-income families and minorities.
Now that telemedicine is so prevalent and is becoming a standard of care, it is important to address the disparities in access to telemedicine. The most important factor in increasing access to telemedicine among the elderly is to improve the usability and ease of use of websites and technology platforms. It would be advantageous for patients to have well-designed websites that are easy to access and developed in a method suitable for literacy training. It should be functional for a variety of populations in order to be easily accessible for those with low digital literacy.
Many of the lessons learned about telemedicine also apply to telepharmacy. Telemedicine and telepharmacy have the potential to extend the reach of health care, especially for people living in rural areas. However, there are some issues that need to be addressed in our health systems in order for telemedicine to reach its full potential.
In order to address these issues, pharmacists and pharmacy managers can learn from these findings and other studies. First of all, training all staff to be aware of health access issues is essential. Additionally, pharmacies looking to expand telepharmacy services should consider digital health literacy and other factors that would hinder optimal outcomes. Pharmacy managers should also look to work with physician providers to combine or bundle telemedicine and telepharmacy services that further optimize care and generate revenue for both practices.
Additional information on the management of technology that supports the process of drug use and the creation and management of value can be found in Pharmacy Management: Essential Elements for All Practice Settings, 5th.
1. Smith B, Magnani JW. New technologies, new disparities: the intersection of e-health and digital health literacy. Int J Cardiol. 2019; 292: 280-282. doi: 10.1016 / j.ijcard.2019.05.066
2. Eberly LA, Kallan MJ, Julien HM, et al. Patient characteristics associated with access to telemedicine for primary and specialized outpatient care during the COVID-19 pandemic [published correction appears in JAMA Netw Open. 2021 Feb 1;4(2):e211913]. JAMA Netw Open. 2020; 3 (12): e2031640. Posted on Dec. 2020 doi: 10.1001 / jamanetworkopen.2020.31640