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Using virtual health to push equity in health care

Meeting the equity imperative in virtual health care through intentional design and deployment

Over the past decade, sectors across the health care industry have invested considerably in virtual and digital health. The area is poised for tremendous growth, as COVID-19 accelerated adoption and incubated vast opportunities for virtual health to improve access to services while delivering safe and convenient care.

What is health equity?

Health equity is the fair and just opportunity for every individual to achieve their full potential in all aspects of health and well-being. Today, the United States faces significant health disparities across many dimensions that are evidence of systemic structural inequities affecting both individual and community health and well-being (these inequities are explored in further detail below). These disparities are also reflected in virtual health care; however, this moment in the industry also presents an enormous opportunity to drive change for the better and unlock value while doing so.

If virtual health programs are designed intentionally with equity as a guiding principle, virtual health could improve access, continuity of care, and care management. These shifts could transform care delivery to be more convenient, accessible, and efficient—ultimately leading to improved outcomes. Beyond the social benefits of improving care, prioritizing equity in virtual health would also help health care organizations achieve a competitive advantage and unlock value by enabling personalized care for expanded customer segments.

To activate this equitable future, organizations should begin by understanding the three main arenas of virtual health inequity: 1) infrastructure and access, 2) digital engagement and cultural competency, and 3) technology development and analytics.

What is virtual health?

At-a-distance interactions that are leveraged to further the care, health, and well-being of consumers in a connected, coordinated manner. To be considered virtual health, all communications and information transfers must occur through nonphysical means either synchronously or asynchronously. Virtual health is unique, as it encompasses engagement across the overall health journey beyond just the act of care, and includes the entire ecosystem of prospective and current consumers including their caregivers, families, providers, employers, and producers.

Digital health equity as an imperative: Why equity drives value

Market, regulatory, and moral incentives for prioritizing equity in virtual health are beginning to align. COVID-19 dramatically accelerated the adoption and reimbursement of virtual health, particularly among Medicare and Medicaid populations. These populations are very different in terms of race, income, and age than those covered under private insurance. The vast rural, elderly, low-income, and racially and ethnically diverse populations covered under Medicare and Medicaid have historically faced disparities in access to not only virtual health but the health care industry at large. These shifts in coverage—combined with expanded internet access among rural, lower-income, and racially and ethnically diverse communities due to investments in broadband infrastructure and 5G—mean the virtual health industry needs to be ready to serve new and more diverse customer segments. Prioritizing equity in the design and delivery of virtual health will allow organizations across the industry to meet these segments’ needs and reap tremendous benefits.

As health care leaders look to design equitable virtual health programs, they will need to better understand the three arenas where virtual health inequities play out and how to address those inequities: (I) infrastructure and access, (II) digital engagement and cultural competence, and (III) technology development and analytics. 

Designing a more equitable future: Smart first steps

Equity must be embedded into all aspects of virtual health solution design, development, and deployment, especially within organizations’ high-level priorities and strategic initiatives. This process should be intentional and human-centered (focused on impact to consumers), as we recently outlined in our virtual health care experience white paper. To activate equity, leaders should:

  1. Adopt inclusive and diverse human-centered design (HCD) practices for technology development to ensure solutions consider underlying drivers of health, account for diverse needs, serve all populations equitably, and do not perpetuate biases (reference Deloitte’s Experience-led virtual health paper for more detail on HCD for virtual health).
  2. Prioritize diversity and equity in the care model design, workforce training, communications strategies, and deployment of virtual health solutions.
  3. Adopt phased implementations that “move at the speed of trust” to drive equitable adoption of virtual health technologies and services.
  4. Establish policies, regulations, and standards to balance protecting consumers, driving equity, and encouraging innovation in virtual health.
  5. Conduct ongoing monitoring of key equity metrics to understand if and how solutions, analytics, and practices impact equity.

As the United States continues to grapple with the disparities laid bare by the pandemic and the staying power of virtual health becomes more and more evident, it’s critical that the health care industry intentionally designs virtual health programs and solutions with equity as a guiding principle.

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