CHICAGO — The American Medical Association (AMA) approved policy today intended to help close the digital divide in access to telehealth services. The new policy will help ensure that minority communities, individuals residing in underserved rural and urban areas, older adults, and individuals with disabilities can reap the benefits and promise of telehealth. 

At the Special Meeting of the AMA House of Delegates, physicians, residents, and medical students adopted policy to promote initiatives to strengthen digital literacy, emphasizing programs designed with and for historically minoritized and marginalized populations. The AMA believes that telehealth solution and service providers—in their design and implementation efforts—need to work directly with the populations their products are meant to help and serve. Culture, language, accessibility and digital literacy must be considered when designing telehealth functionality and content.  

“It is essential for physicians to serve as leading partners in efforts to improve access to telehealth services in historically marginalized and minoritized communities. More of our patients used telehealth during the COVID-19 pandemic, and we should take advantage of this opportunity to ensure all our patients are able to benefit from being able to access and use telehealth services—regardless of their background or geographic location,” said David H. Aizuss, M.D., a member of the AMA Board of Trustees.  

The new policy calls for expanding physician practice eligibility for programs that assist in the purchase of services and equipment to provide telehealth services. This would help strengthen the broadband infrastructure and increase the connected-device use among historically marginalized, minoritized and underserved populations. 

 In addition, the policy recognizes that all health care stakeholders must be involved in the effort to make telehealth available to everyone. In partnership with diverse patient populations, hospitals, health systems and health plans need to launch interventions aimed at improving telehealth access, including leading outreach campaigns. To spread the benefits of telehealth, the AMA will support efforts to design telehealth solutions to accommodate those with difficulty accessing technology – including seniors, vision-impaired patients and individuals with disabilities. 

Telehealth has the potential to address longstanding health inequities, though equity-centric design and implementation will be needed to overcome inequitable resource allocation in underserved areas. In 2019, 25 million individuals in the United States did not have internet access at home, and 14 million did not have equipment capable of playing video—essential for two-way audio-video telehealth—such as a smartphone or computer. Bandwidth issues serve as obstacles to accessing telehealth services even for patients with internet access at home. And for patients who have only a smartphone, two-way audio-video telehealth visits can be a challenge.  

A larger percentage of Black and Latinx individuals do not have internet access at home. And people living in rural areas are less likely to have internet access at home than those in urban areas. 

“So many people have been stuck on the sidelines as telehealth has grown during the COVID-19 pandemic. We must make sure they are not left behind as telehealth moves forward. We must recognize that broadband internet access is a social determinant of health,” Dr. Aizuss said.