It Shouldn’t Be Hard to Help Patients Cross the Digital Divide

As we have clearly seen, driven home even more over the past year by the pandemic, access is a huge part of people being able to successfully achieve the best state of health they can. Over and over, we’ve demonstrated that having a stable base of a healthcare team, the ability to reach them, the ability to engage with the healthcare system and move forward, to get what you need when you need it, is a critical part of trying to build the most patient-centered care we can.

Patients spend, for the most part, a ridiculously small percentage of their life directly in contact with their healthcare providers, which is usually a good thing. Even if a patient sees me multiple times over the course of a year, and we communicate occasionally on the telephone, by email, or through the patient portal, that still probably adds up to less than a few hours a year, and so much of their health is determined by their time away from us.

So if we can figure out the best ways to optimize their getting into see us when they need us, to reaching us when they have a question, to getting the resources they need to carry on in the real world out there, then we are sure to be able to improve all those issues that we are trying to squeeze into a 15-minute office visit.

Access occurs at many different touch points, from trying to reach us to schedule an appointment, to video visits, to follow-up on lab testing, to being able to schedule appointments with specialist providers. And more and more we’ve seen that there are great divides in the equity with which access is dispensed. So many patients are challenged with trying to reach us, whereas others have an easy road. This is just not fair, and needs to change.

Building a better contact center, a group of people dedicated to answering the phones, is one part of it, as long as the people working at the centers are aware of how the practice works and feel they are a part of our team, and can keep updated and in communication with the practice so that things go smoothly. Providers are frustrated enough without messages from the schedulers at an answering service saying, “Please call the patient; they want an appointment.”

We have seen through the pandemic that so many of our patients lack access to the patient portal, which has proved problematic in communicating results to them, and hinders better engaging them in the longitudinal care of both acute and chronic issues. Our patients lack cell phones, home computers or tablets, and access to broadband Internet, and often even tell us that they don’t have enough minutes on their cell phone plans to be able to use them for something like checking the patient portal.

Perhaps we can address this, attack this, take on this challenge, and demand a just world where everyone can get equal access at just the time they need it. As part of infrastructure development in this country, we need to ensure that all communities have access to the Internet, and devices that let them work there. The right answers will have to be public-private partnerships, with cities and corporations working together to build reliable and powerful access in every neighborhood and for every social situation.

In this day and age, when everybody sitting on the bus is watching a movie or playing games on their telephones, no one should suffer at home by not being able to reach their provider, see their results, send us their blood pressure readings, or ask us a question. My solution (and this is a free sure-fire marketing tip for Verizon, T-Mobile, and all the rest of the telecommunications giants) is “medical minutes,” time on every service plan no matter what they pay, that gives people unlimited access to time spent communicating about healthcare. And even free phones/computers/tablets and free plans for those who cannot afford even the basics.

I know, many people are going to argue that this is going to open up the floodgates, that everyone’s going to want to have some minutes dedicated to whatever it is they’re doing, be it education or filing your taxes or whatever, and maybe someday that will be the answer. But really, folks, these minutes aren’t really real; they aren’t a fixed commodity; it’s not costing anybody anything to produce them. Or to give them away.

Think of the great publicity if Verizon figured out a way to let you access your medical records, interact with your healthcare systems, do video visits, and stay healthy. Wouldn’t that be the kind of partnership between healthcare systems and a corporation that would be a win for everyone involved?

Let’s try it and see.

Fred N. Pelzman, MD, of Weill Cornell Internal Medicine Associates and weekly blogger for MedPage Today, follows what’s going on in the world of primary care medicine from the perspective of his own practice.