When Health Care Moves Online, Many Patients Are Left Behind

Amid the coronavirus pandemic, more of the nation’s medical care is being delivered by telephone or videoconference, as in-person care becomes a last resort for both doctors and patients. That’s a problem for tens of millions of Americans without smartphones or speedy home internet connections. For them, the digital divide is exacerbating preexisting disparities in access to health care. Patients unfamiliar with or lacking access to technology already tend not to use online tools that can improve health outcomes and allow them to request appointments and prescription refills, as well as message their doctors directly. Telemedicine was supposed to increase access to health care during a national medical emergency, says Jorge Rodriguez, a physician at Boston’s Brigham and Women’s Hospital who also studies health care technology disparities. But for some, it’s just another barrier. “It’s become a lifeline,” he says, “but not across the board.”

Kim Templeton, an orthopedic surgeon with an oncology subspecialty in Kansas City (KS) routinely tries to connect with patients over videoconferencing after biopsies or reconstructive surgeries. But her rural patients often didn’t have the technology or home internet for virtual check-ins. Instead, many drove five or six hours to office visits. “It’s inconvenient, but it’s worth it,” Templeton says. Now, she can’t ask them to travel to her. In some cases, Templeton says, she can’t even receive their x-rays, MRIs, or CAT scans from rural hospitals or doctor’s offices that don’t have the bandwidth to upload image files to the cloud. Those patients are left to describe healing incisions and lingering pain over the phone. “It can be almost impossible to figure out what’s going on,” Templeton says.