By Jennifer DeYoung, Director of Policy, Building Blocks of Health Reform, United States of Care
Twitter: @USofCare
Virtual care has been heralded as the future in the delivery of health care. But are we looking at it the right way?
Practically overnight, the pandemic forced providers to reimagine the way they care for patients.
Once regulatory flexibilitity was granted — COVID-19 unleashed a revolution in virtual care. But is all the virtual care hype moving us towards a more equitable health care system for those who don’t have good access to care now?
Under virtual care, people can visit with their doctor over a video chat, with a telephone call, or using instant messaging instead of going in-person to their doctor’s office. Some patients can even collect vital information such as weight, blood pressure, heart rate, and blood sugar levels, using remote monitoring equipment that transmits data directly from their home to their doctor.
While there’s no denying that virtual care has filled a critical gap in the system left by the sudden restrictions on physical visits — especially for those that readily had access to their doctor — serious questions remain surrounding the future of virtual care post-COVID.
Our Vision for Virtual Care
At USofCare, we have a vision in which people, policymakers, providers, and entrepreneurs come together to build a virtual care system of the future, centered on people’s needs that closes gaps and removes barriers to access. Under this vision:
- We believe that everyone should have access to quality, affordable health care regardless of health status, social needs, or income.
- Virtual care will be used to remove barriers to access for those who faced additional challenges before COVID-19, while also making health care more convenient for those who did not face access challenges; and
- Virtual care is seen not as an outcome, but one strategy to help people — especially those who have been historically marginalized — access the care they need.
Ultimately, we seek to create:
- People-centered principles to guide health systems in implementing virtual care
- Policy recommendations that are needed to create a virtual care system that works for all of us
- A portfolio of innovative approaches throughout the country where virtual care is reducing disparities in access
- A list of research needs to monitor equity gaps in access
- A system for ongoing evaluation by experts and people to understand where virtual care implementation is aligning with our vision and what more can be done
Why Barriers to Care are Such a Serious Problem
As policymakers and health systems face decisions about turning short-term fixes — like virtual care — into long-term policy solutions, at USofCare, we believe the answer requires:
- Making care more convenient for those without previous access challenges
- Leveraging this opportunity to create a system that can help those that continue to be left behind
We also believe virtual care can best function as an innovative tool to help groups — disproportionately impacted by health inequities — access care in a whole new way. One that goes beyond merely seeing virtual care as an “awesome new tool,” but exploring deeply how we can get virtual care to best meet ALL people’s needs.
Although almost every person encounters barriers to accessing care at some point in their life, specific populations disproportionately bear the consequences, as the COVID-19 pandemic tragically made all too clear. Numerous barriers to care can present themselves differently depending on various factors, including where someone lives, stage in life, financial burdens, and the patient-provider relationship.
- People of color and low-income individuals have faced greater barriers to accessing care, including higher uninsured rates than Whites and those at higher incomes.
- Latino, African American, Indigenous, and Alaska Native nonelderly adults are more likely than Whites to delay or go without needed care.
- Adults with disabilities are almost twice as likely as other adults to report unmet health care needs due to problems with the accessibility of a doctor’s office or clinic.
- Rural Americans are 5% more likely than people in urban areas and 14% more likely than people in suburban areas to say access to good doctors and hospitals is a significant problem in their community.
No longer can our system look the other way when it comes to addressing its health inequities.
How We’re Centering the Virtual Care Conversation on People’s Needs
Through USofCare’s “people-centered health equity approach,” our virtual care work is centered around the needs of people and how people want to access care. We believe that understanding people’s needs and advancing solutions to meet them will build durable solutions that move us towards our future vision for the health care system.
In the coming months, we’ll hold a national listening tour with people, providers, and other key stakeholders to learn about their diverse experiences with virtual care. We want to start with understanding what people’s experience from all corners of our country has been like with virtual care — what’s working for them and what isn’t, and what more they need to feel like they can access the care they need. We’re doing this by listening to people — through one-on-one conversations, trusted messengers, and focus groups. We’re also going to pair this with what the evidence and the experts say so we can see: what we’re missing and what more we can do to ensure an equitable approach with virtual care.
Additionally, we look forward to bringing together expert leaders to support the implementation of these resources, pair what we hear with the research and evidence, and evaluate their impact over time. Our Founders’ Council and Entrepreneurs Council members’ expertise and guidance — many of whom are leaders in developing virtual solutions — gives us unparalleled access to the field’s best innovations.
We plan to use this information to develop tools and resources that policymakers and health system leaders need to create a virtual care system that works for all. Finally, we will turn our findings into action and work with partners in our communities to evolve our virtual care system into one that works for all!
This article was originally published on the United States of Care blog and is republished here with permission.