☆ 4.7 Review

Desperately Seeking Intersectionality in Digital Health Disparity Research: Narrative Review to Inform a Richer Theorization of Multiple Disadvantage

JOURNAL OF MEDICAL INTERNET RESEARCH (2022)

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Summary: The increased use of telehealth during the COVID-19 pandemic has highlighted disparities in access to care. Older patients, English-proficient individuals, and those with activated patient portal were more likely to participate in virtual care. Patient characteristics associated with virtual participation included only behavioural health visits, COVID patients, highest quartile of visit frequency, and multiple visit types. Video participation was more common among younger patients, those with only behavioural health visits, highest quartile of visit frequency, non-Hispanic black race,limited English proficiency, and inactivated portal account.

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Summary: Since the COVID-19 pandemic began, there has been a significant increase in the use of telehealth worldwide. However, certain populations, such as those living in lower socioeconomic areas, culturally and linguistically diverse communities, people with disabilities, and those with low health literacy, are less likely to access telehealth services. This article proposes practical steps to reduce the digital divide and improve equitable access to telehealth, including improving digital health literacy, training healthcare workers in telehealth, co-designing new models of telehealth-enabled care, advocating for culturally appropriate services, and establishing sustainable funding models.

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Summary: This study examines the challenges faced by vulnerable groups in using digital health services during the COVID-19 pandemic. The findings reveal that insufficient digital and/or local language skills, lack of support and training, poor health, and inadequate devices hinder access to digital health services for many participants. Additionally, digital services are not perceived as applicable for all situations and are considered less personal and more prone to misunderstandings compared to face-to-face services. Concerns and lack of trust regarding digital platforms, as well as unawareness of existing digital services, also limit the use of digital health services.

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Summary: Traditional evidence-based medicine approaches have limitations in dealing with complex issues of COVID-19, and a broader range of evidence and a pluralistic approach are needed.

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Socioeconomic Disparities in the Demand for and Use of Virtual Visits Among Senior Adults During the COVID-19 Pandemic: Cross-sectional Study

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Summary: This study revealed that the COVID-19 pandemic has exacerbated existing inequalities in access to healthcare for many migrants, mainly due to digitalization and virtual consultations. In-depth, semi-structured interviews highlighted the diverse beliefs among migrants regarding COVID-19 and potential vaccines, often influenced by misinformation. Innovative solutions, such as translated digital health advice using text templates and YouTube, were suggested for further exploration to address these challenges.

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Alisha R. Davies et al.

Summary: Digital technologies have been widely adopted in healthcare, but issues of digital inequality persist, especially impacting those most in need of support. The COVID-19 pandemic has accelerated the adoption of digital working methods, and it is crucial to act now to prevent digital inequality from contributing to health disparities in the future.

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Yohualli Balderas-Medina Anaya et al.

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Disparities in telephone and video telehealth engagement during the COVID-19 pandemic

Jonathan W. Sachs et al.

Summary: The COVID-19 pandemic and the rise of telehealth have potentially worsened disparities in ambulatory care access due to various institutional and structural barriers. A study conducted at Oregon Health & Science University showed significant increases in video and telephone utilization among ambulatory patients, with certain demographic groups being less likely to use video care modalities. This disparity highlights the need for organizations to monitor telehealth utilization and address potential biases to prevent exacerbating inequities.

JAMIA OPEN (2021)

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Review Medical Informatics

Future and Development Direction of Digital Healthcare

Hun-Sung Kim et al.

Summary: Digital healthcare plays a crucial role in patient-centered healthcare, requiring a deep understanding of both technical and medical aspects. Collaborative efforts from medical staff, patients, and the government are essential for continuous improvement and development in this field.

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Recommendations for Health Equity and Virtual Care Arising From the COVID-19 Pandemic: Narrative Review

James Shaw et al.

Summary: This study aims to provide insights from literature responding to the widespread use of virtual care during COVID-19, with a focus on recommendations for promoting health equity. The review highlights strategies proposed at different levels in the literature and emphasizes the need to simplify interfaces, utilize supportive intermediaries, and involve marginalized community members in the planning and delivery of virtual care to enhance health equity.

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