On March 15, President Joe Biden signed a $1.5 trillion omnibus spending bill that included a variety of new initiatives, including aid to Ukraine, infrastructure investment and the renewal of community project funding. That funding includes about $10 billion in congressionally directed spending projects throughout the country. A CPF request I submitted, backed by Rep. Doris Matsui (D-Calif.) along with the support of 16 regional stakeholders for a Digital Health Equity Program, was included in the bill.
The appropriations process can seem abstract in the value it brings to communities, but it is important that the public appreciates how this investment can make a difference nationwide. The Digital Health Equity Program is a good start to what really is needed: a strategic legislative push from Congress to support permanent telehealth reform to prevent the loss of large-scale telehealth access since the COVID-19 public health emergency and to invest in building equitable access to telehealth.
The pandemic has demonstrated the value of online platforms, especially in healthcare—but equitable access has not matched this growth. During the pandemic, telemedicine helped prevent the spread of COVID-19 in medical facilities by ensuring the majority of the afflicted could be assessed and monitored from home. In addition, it has also created a new lane of care that otherwise the hospital and emergency departments would have to contend with. According to the Pew Research Center, at least 1 in 5 Americans lack smartphone access and/or lack computer access/broadband. Digital disparities in smartphone and broadband access and digital literacy occur frequently in low-income and rural communities, where residents are also greatly affected by health disparities.
Digital health platforms are much broader than simply telehealth. Digital and virtual health moves healthcare from the point of care to the point of need. Digital health platforms help create an interoperable public health infrastructure where providers and patients have timely access to all medical data, regardless of where a service was rendered. Digital health tools allow providers, patients, insurers, and community institutions to maintain close contact between care episodes, enabling lower cost, and more effective models of care. This has the potential to overcome these barriers that contribute to healthcare access inequities. To ensure equity, it is critical to establish regional digital public health platforms to improve access to and continuity of care for vulnerable populations throughout the U.S.
Ultimately, just as emergency departments are front doors to our hospitals that are open to all, digital front doors need to be developed to allow this same equitable access. The scope of services enabled by a digital front door need to be broad and deep: online scheduling, on-demand telehealth visits, subspecialty referral, eConsult services, mobile health coaching, remote patient monitoring, and integrated tele-interpreting services. Digital health navigators will be essential to provide culturally appropriate, high-quality care to effectively use the digital platform. The navigators would be key to ensuring digital literacy and efficient access to care, particularly in our multilingual population.
This vision will become reality more quickly with key legislative priorities to prevent the removal of currently enabled services as well as additional federal funding to augment digital and virtual health. The appropriations process has a direct impact of lives of patients we serve in our communities. We have a window of opportunity to build upon the telehealth foundation laid during the pandemic. A new and better healthcare system can be the silver lining that this emerging technology delivers.
Why the latest federal spending bill matters to digital health equity is written by Dr. Joshua Elder for www.modernhealthcare.com