The COVID-19 pandemic has revealed telemedicine's potential to improve health care delivery and access. In the past year, we have seen rapid expansion of telemedicine, in the form of video and telephone services, the extent of which our health system has never experienced. This expanded access has been most notable for patients with private insurance and ready access to digital technology. However, some historically marginalized populations may also be experiencing improved health care access with the advent of increased telemedicine services. Complicating this trend are recent reports showing persistent disparity in telemedicine uptake based on age, poverty, and urbanicity. As health care professionals, we have a critical opportunity to leverage telemedicine in a way that addresses and closes historical access gaps to achieve health equity.

It's critical to understand that digital connectivity is a basic necessity and a human right as declared by the United Nations. However, access to digital connectivity and its advantages is not evenly distributed within the United States—a condition commonly described as “the digital divide.” We contend, however, that the increasing complexity of digital connectivity (for example, smartphones, tablets, and so forth) renders this term inadequate. Rather than describing people as “technology rich” or “technology poor,” we use “digital equity” to better describe conditions in which populations have access to hardware, internet, viable connection speeds, and skills needed to effectively use these technologies.

Equity is integral to realizing telemedicine's full potential and was recently declared the cornerstone of successful pandemic recovery. In the following, we discuss challenges to equitable engagement with telemedicine services and identify opportunities to improve access for our most vulnerable and disenfranchised patients, with particular attention to the reality that people's inclusion in these categories is dynamic and context dependent.

Read the full article about equitable distribution of telehealth by Rama A. Salhi, Mahshid Abir, Bisan A. Salhi at RAND Corporation.