Although the word telehealth is new in most of our vocabularies, the idea itself is not. As early as 1925, doctors were diagnosing patients over the radio, and in 1959 patients and physicians were using video telecommunications to connect with one another.
Telehealth now, however, is booming. In the year between March 2019 to March 2020, Telehealth usage increased an astounding 154%. Among Medicaid beneficiaries in a select five states, telehealth usage increased 15x from the pre-pandemic usage of 2.1 million visits per year, to over 32 million visits from March 2020 to April 2021.
Although telehealth has its inherent benefits , such as allowing patients to visit doctors from the comfort of their homes, thus saving them time, money, and allowing for fewer missed hours from work, it also has its drawbacks. Disadvantages to telehealth include racial disparities , possible technical difficulties between patient and doctor, misdiagnosis, and privacy concerns.
One of the leading disparities in telehealth is the digital divide. In a study conducted by the University of Houston, head researcher, Omolola Adepoju, found that only one in four families earning $30,000 or less have a smart device capable of running telehealth communications software such as Zoom or Skype. Further, the study found that 66% of African Americans and 61% of Hispanics have high-speed internet access, compared with 79% of white households.
Further challenges were illustrated by the National Center for Biotechnology Information (NCBI), which extracted 27 studies from seven databases, and organized the barriers and challenges to telehealth into seven categories. In order of frequency (most frequent challenge to telehealth, to least frequent): technical aspects, privacy/data confidentiality and reimbursement, physical examination and diagnostics, special populations, training of healthcare providers and patients, doctor-patient relationship, and acceptability and satisfaction.
The second biggest barrier to telehealth, as reported in the NCBI’s report, was privacy/data confidentiality concerns. Patients were afraid that using a telehealth service would subject their intimate data to security breaches. These fears were not baseless. During the COVID-19 public health emergency, the Department of Health and Human Services Secretary Alex Azar issued temporary waivers that waived Medicare’s licensure requirements and allowed health providers to use mainstream video-conferencing platforms like Zoom and Google Meet. Further, smartphone apps, sometimes used in place of Zoom and Google Meet, have been found to share personal health information with third parties.
Although federal policies allowed for health care providers to use popular third party vide conferencing platforms, there are some simple steps we can take to ensure privacy when meeting with health care providers via telehealth. When sharing sensitive health information online, it is important to remember a few precautions we can take to limit the possibility of our information being hacked. First, make sure to keep your devices up to date with antivirus software; second, avoid using public Wi-Fi when accessing telehealth services; and third, avoid accessing telehealth appointments on shared devices. Further, once in an appointment, try to ensure that you are in a private room away from others, and if impossible, let your healthcare provider know, and then you may be able to send sensitive information via text or email through their own protected portal rather than speaking aloud.
As COVID-19 cases are trending down and are presenting less of a public health emergency (which the Department of Health and Human Services plans to officially end on May 11, 2023), it is time for lawmakers and politicians to seriously think about the impacts unregulated telehealth has on the privacy of its users, especially as it relates to marginalized groups.