High-speed internet proves an obstacle as telehealth services continue to grow in popularity – Boston University News Service


By Haley Chi Sing
Boston University Statehouse Program

BOSTON — The COVID-19 pandemic has forced nearly every business and industry to go virtual overnight, including the healthcare system. Medical consultations, physical exams and check-ins have all moved online and almost two years later it seems more people are preferring this method, with telehealth services being used at 38 times the levels than before the pandemic.

Despite the positive feedback from patients, legislators and doctors are asking the same question: can we conduct a real virtual consultation – whether physical or behavioral – when the patient does not have the appropriate equipment to connect to his appointment? ?

“Before the pandemic, we focused on barriers such as lack of transportation or the inability to miss work as major barriers to getting care,” said Dr Ateev Mehrotra, Professor fellow in health care policy 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, specifically black and latin communities who were not close to clinics and doctors. These demographics were also found to be much more susceptible to contracting COVID, further pushing ethnic minorities toward virtual consultations.

“The digital divide impacts poor communities and communities of color disparately,” said CEO Michael Curry. in a statement released by the Massachusetts League of Community Health Centers.

According to Boston25, about 1,200 families in Boston alone did not have internet access in August 2020, along with many other reports, they had no computers at home. MassINC reported that 40 to 50% of households that have Internet access totally lack broadband service. Without basics like computers and adequate internet access, neither doctor nor patient can make an appointment.

As the digital divide continues to become more apparent, state legislators are actively looking for ways to support low socioeconomic demographics through funding and bill proposals to expand broadband internet.

“Researchers have found that access to high-speed Internet is a social determination of health. And then it became even more obvious or more important with the pandemic and with COVID,” Rep. Danillo Sena, D-Acton, said.

Sena is a leading supporter of the call 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 public housing funding, through which tenants would be guaranteed broadband access throughout the building.

“Broadband access or access to the Internet and Wi-Fi has become a right, not a privilege,” Sena said. “That’s why we introduced this bill because it’s so important that people have access to Wi-Fi.”

On a much larger scale, the Massachusetts Senate passed the Patients First Act in 2020 as a means of ensuring that all residents of the State have access to and appropriate health services. Since then, Senate Speaker Karen Spilka, D-Ashland, has made it one of her top priorities to ensure that all Massachusetts residents have equitable access to telehealth, including high-speed internet.

“Part of this [Gov. Charlie Baker and the Senate] to talk is to reach out and be connected with communities across the state that either have solid broadband access or don’t,” 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 increase their access and have it on a more reliable basis.”

According to Spilka, the Senate has bolstered funding for ARPA through various bills and proposals to expand Internet access to lower socioeconomic groups. ARPA funding is also underway to provide financial assistance to residents who cannot afford the required internet fees.

“We just need to work harder to make sure every zip code in Massachusetts has strong, reliable broadband and internet access and the ability to get online,” Spilka said.

Similarly, 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 an integral part of 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, Chief Equity Officer health from MHA. “MHA and our members are working 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 being 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 ends,” said Mara McDermott, Vice President at McDermott+Consulting.

Stephen Bernstein, a McDermott Will & Emery partner, spoke on that same memo, explaining how the government is likely to revert to stricter pre-pandemic health and infrastructure policies rather than expand on new needs.

“The fear is that as the feds turn this easing off – they haven’t yet – and various states start to do the same, that there will be a world of automatic rewind in time 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 that?

With a new governor taking office in 2023, lawmakers say the next steps for expanding broadband and telehealth in Massachusetts remain unknown. But there is optimism.

“I think it’s something we’ve made progress on, we have to keep working on it,” Spilka said. “And I imagine whoever is governor will continue to take over because it’s so important for the health of our residents, for economic vitality, for our community and for the education of our residents as well.”


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