The COVID-19 pandemic has forced almost every business and industry to go virtual overnight, including the healthcare system. Doctors’ consultations, exams, and recordings have all been put online, and almost two years later, it seems more people prefer this way, with telehealth services being used at 38 times more than before the pandemic.
Despite positive patient feedback, legislators and physicians alike are asking the same question: can you conduct an appropriate virtual consultation – whether physical or behavioral – when the patient does not have the proper equipment to connect to the clinic? his date?
“Before the pandemic, we focused on barriers such as lack of transportation or the inability to take time off work as major barriers to obtaining care,” said Dr Ateev Mehrotra, associate professor of policy of health and medicine at Harvard Medical School. “Lack of Internet access is a new barrier that many patients face in accessing care. “
Telehealth services have proven useful in treating minority and underserved populations, especially black and Latin communities who were not near clinics and doctors. These demographics have also been found to be significantly more likely to contract COVID, pushing ethnic minorities further into virtual consultations.
According to Boston25, about 1,200 families in Boston did not have internet access as of August 2020, and many more said they did not have computers at home. MassINC reported that 40 to 50% of households with Internet access lack broadband service entirely. Without the basics like computers and proper internet access, neither doctor nor patient can make an appointment.
As the digital divide continues to become more apparent, state lawmakers are actively seeking ways to support the low socio-economic demographics through funding and bill proposals to expand broadband internet.
“Researchers found that broadband internet access was a social determinant of health. And then it became even more evident or more important with the pandemic and with COVID, ”said Representative Danillo Sena, D-Acton.
Sena is one of the main supporters of a petition for a formal investigation into the relationship between broadband internet and public health services in Massachusetts. Sena said the first steps proposed by the bill would include funding for public housing, through which tenants would be guaranteed broadband access throughout the building.
“Broadband access or access to the Internet and Wi-Fi has become more of a right than a privilege,” Sena said. “This is why we introduced this bill, because it is so important that people have access to Wi-Fi.”
On a much larger scale, the The Massachusetts Senate passed the Patients First Act in 2020 as a means of ensuring access and appropriate health services for all residents of the state. Since then, Senate Speaker Karen Spilka D-Ashland has made it one of her top priorities to ensure equitable access to telehealth for all Massachusetts residents, including high-speed internet.
“Part of what (Governor Charlie Baker and the Senate) is talking about is contacting and being in touch with communities across the state that have or don’t have strong broadband access,” Spilka said. “And the state, I think as a whole, has made a conscious effort to try to help communities in different parts of the state to increase their access and have it on a more reliable basis.”
According to Spilka, the Senate has boosted funding for ARPA through various bills and proposals to extend Internet access to lower socio-economic demographic groups. ARPA funding is also underway to provide financial assistance to residents who cannot afford the required internet fees.
“We just need to redouble our efforts to make sure that every Massachusetts zip code has strong, reliable broadband and Internet access and is able to connect,” said Spilka.
Likewise, private entities including the Massachusetts Health and Hospital Association are also working to overcome this digital barrier, including seeking partnerships with state government officials.
“Telehealth is integral to the future of our healthcare system, but it will only reach its full potential when it is available to everyone across the Commonwealth,” said Akriti Bhambi, Director of Equity in MHA health. “MHA and our members work in partnership with our elected leaders to ensure that all members of the community, regardless of location or means, can use virtual services to the fullest extent possible. “
As the private and public spheres begin to work together to promote equitable telehealth services, the extent to which these partnerships can expand broadband access is questioned.
“There are some pretty archaic Medicare regulations that restrict … where telehealth services can be offered to beneficiaries in a post-pandemic landscape that I think many hospitals are looking to see addressed by the federal government before the pandemic is over.” said Mara McDermott, vice president at McDermott + Consulting.
Stephen Bernstein, McDermott Will & Emery partner, spoke on the same note, explaining how the government is likely to revert to stricter health care and infrastructure policies ahead of the pandemic rather than expanding new ones. needs.
“The fear is that as the federal government turns off this easing – they haven’t done it yet – and various states start to do the same, that there will be an automatic rollback world. where the old rules apply automatically. And I think that’s what’s happening as a result, ”Bernstein said. “It’s crazy. We’ve made progress. Why would you want to do this?”
With a new governor taking office in 2023, lawmakers say the next steps in Massachusetts broadband and telehealth expansion remain unknown. But there is optimism.
“I think this is something that we have made progress on, we have to keep working on it,” Spilka said. “And I imagine the governor will continue to take over because this is critically important to the health of our residents, to economic vitality, to our community and to the education of our residents as well.”
Haley Chi-Sing is a reporter for the Boston University Statehouse Program.