Virtual care: Ensuring all patients have access

HHS offers guidance on avoiding discrimination against those with disabilities or limited English proficiency.

Providers and developers of technology solutions need to ensure that patients with disabilities can also take advantage of virtual care offerings.

The integration of virtual care into the delivery of healthcare is opening new doors for access and patient interactions. But some patients, especially those with disabilities or limited English proficiency, may not be able to experience all the benefits.

Developers of virtual care tools as well as clinicians utilizing those tools should make it a priority to enable all patients to obtain access to virtual care.

HHS guidance

Recently issued guidance from the Department of Health and Human Services describes how to avoid unintentional discrimination in the use of virtual care tools.

The aim is to provide a reminder that nondiscrimination laws apply regardless of the setting in which care is delivered or the modality used to deliver the care.

The law does not distinguish between in-person or remote care, so the same considerations should be applied in both settings.

Access for disabled individuals

In addressing individuals with disabilities, the HHS guidance considers providing access to the virtual care tools as well as ensuring effective communication.

HHS states that individuals with disabilities should not be excluded from the use of virtual care solutions. Assuming a disability could inhibit the use of virtual care denies those patients the opportunities and benefits that may arise from the tools.

The agency explains that, for example, a clinician should avoid, assuming that an individual with an intellectual disability will not understand how to navigate the virtual care platform. Each patient should be given the chance to use the platform, and materials or instructions should be reframed, as necessary, to ensure that all can understand them.

HHS also addresses the need to provide reasonable accommodations or modifications to help support patients’ use of the tools. That could mean providing additional time before, during or after a visit or allowing the patient to have additional individuals with them on a visit.

It all comes down to understanding the needs of individual patients and working to have tools that support those needs.

Regarding communication, the HHS guidance focuses on individuals with visual or aural impairments. In both cases, integration of alternative forms of conveying information, whether text or text to voice, may be necessary, the guidance points out. Such measures mirror what must occur for in-person visits.

Limited English proficiency

The HHS guidance also addresses enabling access for individuals that may not be proficient with English.

Support for these individuals is an essential component of avoiding discrimination based on national origin. Promoting access means offering language assistance services. That includes, for example, providing written communications in more than one language as well as offering interpretation services.

Again, virtual care is just a different platform for delivering the same services that can occur in person, so the same supports must be in place.

Equity in virtual care

Being aware of the need to make virtual care fully accessible to all patients requires carefully considering how individuals may approach use of a particular virtual care tool.

Pushing ahead without that awareness can create unintentional blind spots because one individual may not have all the necessary experiences to consider the full spectrum of care approaches.

After awareness comes intentionality. Organizations must make a long-term commitment to incorporate the requirements and keep evolving their policies to remain compliant. Those efforts can involve a significant amount of work, but the benefits make it worthwhile.

Providing high-quality healthcare requires ensuring that all patients can benefit from the most appropriate services. As healthcare continues to undergo innovation and movement to a new continuum of care, all must be able to benefit.

Matthew Fisher is general counsel for Carium. This column previously appeared on the Carium website here.

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