Telehealth
Hi! This is my first research at the University of South Florida with Undergraduate Research Society.
The Potential Role and Effectiveness of Telehealth for Healthcare-deprived or Low-resource Communities Globally
🔬 Maribel Serracin, Giang Ha, Chelsea Gabarron, Maria Hanna, Maddie Jarzabek, Archana Rao, Lauren Song, Gayathri Mannem
Presented at: Undergraduate Research Conference at the University of South Florida.
Timeline: Oct 2023 - April 2024
Key Tools: Rayyan
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Research Overview
Abstract
During and following the COVID-19 pandamic, the use of telehealth has been greatly increased due to its effectiveness in providing contactless healthcare. Telehealth has particularly shown promise in reaching people who cannot access in-person healthcare due to reasons incuding but not limited to scarcity of neaby medical centers, lack of transportion, and lack of finances.
This systematic review evaluates experimental and review articles to determine the global impact and effectiveness of telehealth practices. The results of this review demonstrated that telehealth has greatly improved accessbility and facilitating easy access to information through e-record systems.
Telehealth has also made improvements in quality of care for underserved populations and in closing the healthcare gap between urban and rural patients. Telehealth has been particularly beneficial in areas such as cancer screenings, chronic condition management, addressing acute medical emergencies, and pediatric care.
However, research has also found that while telehealth can close mobility and transportation gaps, disparities due to insufficient internet, lack of access to devices, and language barriers continue to persis.
Overall, this review has determined that telehealth has significant benefits for improving access to and quality of medical care, especially for people in rural or underserved areas. However, it is important to address continuing disparities through further research such as by exploring training for healthcare professionals and investigatin how to close telehealth-related barriers for certain demographics such as older adults and racial and ethnic minorities.
Introduction
The COVID-19 pandemic has changed the landscape of healthcare delivery worldwide, fostering the expansion of telehealth. Telehealth utilization represents an adaptation to the challenges of providing continous healthcare admist restrctions on physical mobility and social distancing. The pandemic have thrust telehealth to the forefront, showcasing its potential to bridge gaps in access to healthcare services. The shift towards telehealth opened new avenues for patient care, extending reach of medical services to populations that previously faced substantial barriers to access.
This review aims to assess the global impact and effectiveness of telehealth practices during and follwong the pandemic, evaluating its role in enhancing accessbility, quality of care, and its potential in mitigating healthcare disparities.
By analyzing scholarly articles, it seeks to understand how telehealth has improved healthcare accessbility and quality, especially for those previously hindered by distance, transportation issues, or financial limitations, while also acknowledging ongoing disparities such as internet access, device availability, and language barriers. The review intends to offer insights into telehealth’s benefits and areas requiring further research to enhance its equity and effectiveness across all demographics.
Methods and Materials
Articles discussing the effects of telehealth on healthcare-deprived and low-resource communities were collected and screened throguh Rayyan. A systematic review was then conducted to filter through various study methods and variables to determine relevancy to the research topic.
Results
| Authors | Year | Title | Journal | Type of Study | Main Findings |
|---|---|---|---|---|---|
| Ramirez, et al. | 2020 | Telemedicine in Minority and Socioeconomically Disadvantaged Communities Amidst COVID-19 Pandemic | NCBI | Literature Review | Cultural views influence attitudes; minorities chose Telehealth due to linguistic/economic barriers to in-person care. |
| Rush, et al. | 2022 | Telehealth Use for Enhancing the Health of Rural Older Adults: A Systematic Mixed Studies Review | NCBI | Systemic Review | Telehealth is a cost-efficient method for rural healthcare compared to traditional consultations. |
| Ramsey, et al. | 2023 | Children with uncontrolled asthma from economically disadvantaged neighborhoods… | NCBI | Literature Review | 60-70% of children with asthma miss appointments due to transport; Telehealth enables home-based treatment. |
| Jaffe et al. | 2020 | Health Inequalities in the Use of Telehealth in the United States in the Lens of COVID-19 | NCBI | Literature review | Majority were mental health seekers; rural use lower than urban; 845% surge in outpatient Telehealth during COVID. |
| Schwamm et al. | 2014 | Telehealth: Seven Strategies To Successfully Implement Disruptive Technology | Health affairs | Literature Review | 7 success strategies: patient/provider expectations, revenue models, deconstructing traditional care, etc. |
| Bowman et al. | 2022 | The “Telehealth Divide”—Who Are the Underserved, and What Care Is Improved? | JABFM | Systematic Review | Examines racial disparities in wellness, visits, drug safety, and medical abortion post-pandemic. |
| Glassman Paul | 2012 | Using Telehealth Technologies to Improve Oral Health for Vulnerable… | JCDA | Literature Review | Emerging evidence that telehealth enhances oral health delivery for vulnerable/underserved populations. |
| Ghaddar Suad | 2020 | Understanding the Intention to Use Telehealth Services in Underserved Hispanic Border Communities | JMIR | Systematic Review | Measured attitudes at Texas-Mexico border; Telehealth literacy fosters positive feelings toward the service. |
| Jewitt et al. | 2021 | Telehealth: Reducing or increasing cancer care disparities? | JCO | Systematic Review | Shows disparities among historically underserved cancer patients of varying ethnicities and ages. |
| Flack Paul et al. | 2004 | Addressing Mental Health needs of the rural underserved | Contemporary Family Therapy | Literature Review | Mental health services effectively delivered via distance tech; requires tech accommodations for both parties. |
| Marcin et al. | 2015 | Addressing health disparities in rural communities using telehealth | Pediatric Research | Literature Review | Improves satisfaction and reduces costs; addresses geographic maldistribution of pediatric specialists. |
| Bailey et al. | 2021 | Early Patient-Centered Outcomes Research Experience With the Use of Telehealth to Address Disparities | JMIR | Literature Review | Disparities reduced by patient-centered care and strong provider-patient connections. |
| Chambers et al. | 2012 | A cross-sectional survey and service evaluation of simple telehealth in primary care | BMJ | Systematic Review | High satisfaction; easy to use; schedule flexibility and improved hypertension education in general population. |
| Ahmed et al. | 2015 | Portable Health Clinic: A Telehealthcare System for UnReached Communities | SpringerLink | Original research | Successful in Bangladesh for NCDs/aging; reduces morbidity; drawback: cannot handle communicable diseases. |
| Sammy Le et al. | 2021 | The application of telehealth to remote and rural Australians with chronic neurological conditions | Wiley | Original research | Rural Australians highly satisfied; 100% would recommend; beneficial for chronic conditions without re-exam. |
| Hochman et al. | 2000 | Cardiogenic shock complicating acute myocardial infarction–etiologies… | Elsevier | Original research | Smartphone-paired ECG/Echo in Zimbabwe; data sent to US specialists; identified CVD in high-risk populations. |
| Thota et al. | 2020 | Telehealth is a Sustainable Population Health Strategy to Lower Costs… | ASCO | Original research | Saves time/money for rural Utah patients; barriers include staffing, training, and maintenance. |
| Vadheim et al. | 2017 | Telehealth delivery of the diabetes prevention program to rural communities | Oxford Academic | Original research | Comparable results to on-site programs in weight loss/participation for rural communities. |
| Moffatt & Eley | 2010 | The reported benefits of telehealth for rural Australians | CSIRO Publishing | Original research | Potential to reduce access lack in rural Australia; requires practitioner upskilling for implementation. |
Discussion
The latest study underscores the positive impacts of telehealth utilization within communities, especially those catering to healthcare-deprived or low-resource demographics. However, it also brings attention to pertinent issues, particularly from an economic standpoint, as the costs of essential telehealth equipment pose a significant challenge.
By addressing these challenges directly, it can be ensured that telehealth’s influential promise is fulfilled, resulting in more equitable access to healthcare services for all individuals, regardless of geographical location or socioecnomic status.
Conclusions
Telehealth initiatives have demonstrated significant strides in extending their reach to underserved populations, including within developing nations where technology adoption remains sparse. Health care professionals advocate for Telehealth, asserting that the caliber of care delivered via this digital platform is commensurate with that of traditional in-person consultations. Its applicability ranges from chronic disease management to acute emergency situations, enhancing accessibility and quality of healthcare services. Moreover, with the improved accessbility of medical information through research programs like INvest clinical trials and initiatives like GIVE, remote healthcare services are expanding. For example, a study conducted revealed that more than half of children who suffer from asthma fail to attend their in-person medical appointments due to transportation difficulties.
Telehealth has played a crucial role in overcoming these financial and logistical obstacles, enabling families globally to access medical care from a physician without the burdens that traditionally hinder patient care. The findings from scholarly articles provide insightful and quantitative evidence on Telehealth’s positive effect on various communities, such as low-income families and the elderly.
