From Department of Family Medicine, David Geffen School of Medicine, University of California, Los Angeles (YBA, ABM); Center for the Study of Latino Health and Culture, David Geffen School of Medicine, University of California, Los Angeles (GDH, AO, and DEH).
J Am Board Fam Med. 2022 May-Jun;35(3):588-592. doi: 10.3122/jabfm.2022.03.210509.
National telehealth policy thus far has focused on broadening access to service, specialties, and originating sites. Yet telehealth policy can further equity by providing system-level change needed to reduce structural determinants that hamper telehealth access in historically marginalized, low income, and limited English-speaking populations. The authors propose policy solutions for states and CMS to help address these structural determinants of telehealth care. A telehealth "ecosystem" grounded in the following core components would ensure equitable access to care: use of technology inclusive of economically marginalized patients, access to the technology and broadband for completing virtual visits, and concrete support for patients as they develop their digital and telehealth skills.
国家远程医疗政策迄今为止一直专注于扩大服务、专业和发起站点的可及性。然而，远程医疗政策可以通过提供系统层面的变革来进一步实现公平，这些变革可以减少在历史上处于边缘地位、收入较低和英语能力有限的人群中阻碍远程医疗获取的结构性决定因素。作者为各州和 CMS 提出了政策解决方案，以帮助解决远程医疗护理的这些结构性决定因素。一个基于以下核心组成部分的远程医疗“生态系统”将确保公平获得护理：使用包括经济上处于边缘地位的患者在内的技术，获得完成虚拟访问的技术和宽带，以及为患者提供具体支持，帮助他们发展数字和远程医疗技能。
