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Leaders of healthcare systems have long understood the benefits of telehealth, and the COVID-19 pandemic has shown that healthcare systems have the capacity to rapidly adopt digital solutions. In just six months, we have seen a decade’s worth of digital transformation. For example, 46% of U.S. consumers are now using telehealth compared with just 11% in 2019. But will the benefits of telehealth be experienced by those who could benefit most?

With face-to-face interactions restricted, telehealth has allowed health systems worldwide to provide patients with access to ongoing care. Digital solutions such as remote patient monitoring (through devices or patient-reported outcomes) and video clinic visits have helped bring healthcare providers and patients both back in touch, and simultaneously, into unchartered waters.

The rapid reshaping of the way care is delivered and received has increased our reliance on the internet to access healthcare. In an ideal world, telehealth and other forms of technology-enabled care would improve access to healthcare in areas where access is limited. However, limited access to the internet has resulted in a healthcare “digital divide” – defined as the gap that exists between individuals who have access to modern information and communication technology and those who lack access.3

Recognizing the Digital Divide in Healthcare 

Those fortunate enough to have unlimited access to telehealth platforms may be surprised to find that 41% of the world’s population doesn’t have internet access.2 There are many reasons for this digital divide, including personal, socioeconomic and structural barriers, such as limited digital literacy and geographic isolation. With the continued threat of COVID-19, these barriers can mean the difference between life and death.

Unfortunately, these health inequalities are likely to worsen as we begin to rely more on digital services in healthcare. As health systems continue to be digitized, it’s important to understand barriers to patient access so we can address them:

  • Age: There is a wide disparity in internet use between people age 18 to 29 and those age 65 and older. Fewer older people engage with smartphones and computers regardless of whether the technology is easily accessible to them. Research has shown that generations that didn’t grow up with limitless technology solutions need more training to gain a good understanding of new technologies, especially those regarding healthcare.4
  • Socio-economic background: While 87% of people in developed countries use the internet, only 19% of those in developing countries do so.5Having a lower income and being of minority race or ethnic background not only impedes people’s access to health services but presents an added barrier to accessing telehealth. Recent research has shown that the proportion of non-Hispanic white patients accessing health services was approximately 40% higher than for Black/African and Latinx patients since the COVID-19 outbreak began.6 This represents a potentially life-threatening reality in a time of digital transformation.
  • Geographic location: In the United States, one in four rural Americans does not have internet access at home, primarily due to fewer telephone lines and internet cables in those areas.7 Reduced connectivity to telehealth services could lead to health complications for rural populations.

Bridging the Gap  

Addressing these barriers and minimising health inequality and ensuring digital health is inclusive is possible with the following:

  • Telephone consultations – including call-back or freephone telephone services that provide an alternative to online video consultations
  • Telehealth kiosks – providing accessible care in areas of limited broadband access. Such units can be installed at pharmacies, supermarkets and recreation centres.
  • Telehealth literacy training – promoting the use of publicly available services (e.g., community centres and libraries) to provide resources and training to communities with low digital literacy
  • Accommodating language barriers – providing translating capabilities for telehealth websites and applications in a variety of languages
  • Internet as a basic need – governments can work toward prioritising improved broadband access for the most disadvantaged populations

As the COVID-19 pandemic continues worldwide, it will be important to identify even more ways to increase access to telehealth and ensure that people with limited access to the internet aren’t left behind.


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References:

  1. Telehealth: A quarter-trillion-dollar post-COVID-19 reality? 2020. https://www.mckinsey.com/industries/healthcare-systems-and-services/our-insights/telehealth-a-quarter-trillion-dollar-post-covid-19-reality.
  2. Digital users worldwide 2020 . https://www.statista.com/statistics/617136/digital-population-worldwide/.
  3. Steele C. What is the Digital Divide? | Digital Divide Council. 2020. http://www.digitaldividecouncil.com/what-is-the-digital-divide/.
  4. Vaportzis E, Clausen MG, Gow AJ. Older adults perceptions of technology and barriers to interacting with tablet computers: a focus group study. Front Psychol. 2017;8:1687.
  5. Staines R. Digital divide threatens health and wellbeing during pandemic – UN -. Pharmaphorum.com. 2020. https://pharmaphorum.com/news/digital-divide-threatens-health-and-wellbeing-during-pandemic-un/.
  6. Insights on racial and ethnic health inequity in the context of COVID-19, 2020. https://www.mckinsey.com/industries/healthcare-systems-and-services/our-insights/insights-on-racial-and-ethnic-health-inequity-in-the-context-of-covid-19.

Covid-19 exposes digital divide in healthcare. Direct Relief. 2020. https://www.directrelief.org/2020/05/covid-19-exposes-digital-divide-in-healthcare/

COVID-19 has accelerated a race to the middle for technology, engagement, connectivity and strategy, changing business forever  

One of the unforeseen benefits of this pandemic is an accelerated adoption of digital as an operating model for organizations and a behavioral mindset for customers and employees. From the elimination of silos to the seamless transference of work and ideation, we’re experiencing a more efficient system of productivity and excellence. Organizations are moving from transactional to sustainable relationships, utilizing technology and data to forge greater engagement and connectivity based on knowledge and newfound insight.

For communicators and marketers, this intersection is defining a new reality for:

  1. Brands – Digital is translating static brands to dynamic lifestyles.
  2. Innovation – Companies no longer own innovation. Rather, customers are dictating what comes next, sharing new ideas that defy the status quo.
  3. Knowledge acquisition – Digital accelerates the entire concept of idea creation and solutions, pushing companies and employees to new heights of value creation.
  4. Organizational culture – The way we work, interact, organize, recruit, develop and collaborate takes on new meaning as attitudes and values are shaped by a more focused view of purpose over profit.
  5. Trust and relevance – These will be the bedrock of company existence but ever-shifting as the marketplace and customers become more confident and able to better discern given the plethora of information and context available.

Given this upheaval, leaders are looking to devote time and capital to redesigning their approaches to marketing and communications, specifically employee communications and engagement, content and new technologies to understand influence, opinion, relevance and customer preferences. Less time and activity is being given to such legacy processes as long-term strategic planning, product development and employee satisfaction. Digital is rendering such time-consuming and limited activities obsolete. Agility and speed are now the north star for organizational success.

“Probably the most difficult decision a CEO makes is to disrupt a business model that once worked.”

However, there is one other area that is being dealt with as part of this seismic change: business design. That is, how an organization is organized and designed for optimum value to its stakeholders. Probably the most difficult decision a CEO makes is to disrupt a business model that once worked. Doing so means the very core of the enterprise is shaken. New pieces come into view. Priorities shift. Contradictions happen for a time. People’s lives are turned upside down. Losses may happen for a time. The company’s narrative may be lost.

But through it all, staying the course and redefining the business model in a digital world is ultimately what saves a company or brand from future demise.

The Digital Intersection is happening right before our eyes. To navigate through this landscape, we suggest you consider the following reference points:

  • Signal the Change – Be upfront about what’s taking place and what it means.
  • Adopt Technology – Don’t protect yesterday; forge ahead to what’s next.
  • Follow the Data – Insight will determine the direction.
  • Start New Conversations – Do this specifically with employees; be provocative; be contextual; be empathetic.
  • Recognize It Won’t be Clean – People won’t necessarily understand right away; keep moving forward.
  • Focus on Relevance – This is the balance of what you want to say and what stakeholders hear.
  • Be Forthright – Never waver in your journey. Ever.

COVID-19 continues to impact our lives and will for some time. Assimilating the changes we’ve experienced and enacted means developing a whole new playbook from which to operate.

Coming through the other side with our integrity and our efficacy intact albeit with a whole new worldview is the goal.

Gary


W2O’s additional COVID-19 coverage

Learn more about W2O via our About or Healthcare pages

Last month, we spoke with Dr. Robert Fullilove, Associate Dean for Community and Minority Affairs, Professor of Clinical Sociomedical Sciences at Columbia University and the co-director of the Cities Research Group, where he’s researched the health of people from ethnic minority backgrounds, with a focus on infectious diseases and HIV. An expert on racial inequity in health care, Dr. Fullilove comes from a family of physicians and was an integral part of the Civil Rights movement from 1964 to 1968 alongside Martin Luther King Jr., and his work has even earned him a place in the Smithsonian. 

Dr. Fullilove’s passion for art, science, and international affairs brought us a unique perspective on health inequalities in the time of COVID-19. Dr. Fullilove shared his thoughts on racial disparities in the United States and abroad, comparing COVID-19 with HIV and explaining how pharmaceutical companies have a role in bridging gaps in care.

Read below for some key insights, which have been edited for clarity.

On Access

“The biggest issue that I see is the fact that now, we are at the point where we can manage COVID-19 quite well once it’s diagnosed. However, there are significant delays in diagnoses and results in testing centers that minorities have access to, which is really the difference between life and death. Not to mention the lack of hospitals in minority communities in the first place creates even more issues.”

“What’s more, a lot of what is occurring in minority communities with COVID-19 is because of the fear of high costs deterring folks from seeking out the care that they need.”

“Most importantly though, is the fact that it also comes down to political will or lack thereof. We have all the data and know about all the problems affecting these communities and how to solve it and it’s still not working out so well for us. The impact of COVID-19 on minority communities in America is a functioning tragedy.”

On Potential Solutions

“There has been so much ongoing dialogue and literature that describe in incredible detail obvious, easy solutions that can be implemented in less than seven shakes. However, in health and the health sciences, we presume that everyone is rational and logical, meaning that if we provide enough information, most people will make rational health-based decisions.”

“But that’s not the case: we have the information, we’ve already explained time and time again on how to wear masks, where to get tested, etc., but the science has failed. And that’s not a new thing; in the U.S. 96% of adults understand what HIV is, how to contract it, and how to prevent it, however, we still face around 40,000 new cases every year. Why is that? Because it’s not about logic; it’s about emotion. There needs to be an effort to share a message, to sell an emotion or behavior. This is where science and communications comes together.”

On the Difference Between HIV and COVID-19

“When HIV first hit communities of color, it no longer became a pandemic of national urgency. With COVID-19, it’s everyone’s problem. The disease does not care about race or class; we’ve seen world leaders and local government organizers get sick, making it clear that this is something that can’t be ignored by certain groups.”

On How Pharma Can Make a Difference

“Speak to the gatekeepers of the communities you’re trying to reach. Find out what would be useful and ensure that the representation on your end matches with the community you are trying to help. Additionally, work with charity hospitals in the respective communities who have an obligation to provide community health needs assessments under the Affordable Care Act. Work closely with these hospitals and a board of community advisors to create and vet a plan of action because that will truly make a sustainable and significant impact.”


Learn more about W2O via our About or Healthcare pages.

Over the last five months amid this pandemic we have all been afforded the chance to realign our thinking, our schedules, our priorities, and in a few instances, our purpose. For me, this time has resulted in a journey of personal and professional change.

My family celebrated our son’s high school graduation with pride and then just recently we saw him off to college and a whole new life of discovery, knowledge and friendships. We experienced how our daughter continues to grow into a confident and caring young woman with hopes and dreams for her future. It’s been a time for my wife Audra and me to enjoy the present while envisioning the future.

During this time, I also made a commitment to get healthy. Walking, exercising, eating better, and adopting a healthier lifestyle has resulted in losing over 40 pounds to date. Not easy I can assure you.

So why am I sharing such personal things?

What does it all really mean? The common thread is: Change, Growth, Development, Discipline, Purpose and Performance.

My personal journey in many ways mirrors my professional travels. I’ve had many experiences and emotions seeing my colleagues adapt and adopt behaviors to not only survive but prosper. Before COVID and the Black Lives Matter movement galvanized us further, W2O was already moving at light speed, growing the business, acquiring new capabilities, bringing people together and delivering results for our valued and trusted customer organizations and brands. As such, it was rather difficult to see past all of that and focus on other more human aspects of the business. Similarly, on a personal level missing the little things, ignoring tenets of health and happiness and taking note of life’s nuances, actually impedes growth and the ability to scale as healthfully as possible.

These last several months have unveiled a new and richer chapter in my personal and professional evolution challenging, energizing and pushing me and everyone in W2O to be there for loved ones, customers and each other. It had made us view our ourselves and our business through a real and sometimes raw lens making us uncomfortable, proud and agitated all at the same time.

2020 will be remembered as the year the world stopped, literally and figuratively, allowing people to:

  • Appreciate their health
  • Respect each other always
  • Listen and hear again
  • Maneuver around physical and virtual barriers to achievement and relationships
  • Reach out and empathize with another’s reality
  • Focus on what matters 
  • Make life meaningful

We’ve been given an advanced education on many levels from a business and personal perspective. To scale properly — that is, become stronger, more resilient, and confident — it’s important to set your foundation right. To assign your time and resources to the most high-valued, high-return aspects of your life and organization. To get your relationships right. To be clear and forthright about your purpose.

Personal health and organizational health means being focused on the most important factors.  What I’m learning every day is that change isn’t easy. Never has been. But perseverance, self-awareness and discipline are key. Having fun. Being attentive. Poking fun at yourself and others. Being curious. Shaking things up. Sweating. Respect. Listening. Being Accountable. Seeing ahead. Creativity. And of course, love.

As such, we will come out of this pandemic stronger, fitter, more confident and better suited to address controversy and unexpected events. My personal journey is a great metaphor for W2O to transform itself for what’s next. For the future.

Jim

It’s always a unique pleasure when I get to chat with one of my colleagues for What2Know. W2O’s Global Privacy Officer, Dan Linton, joins the show to discuss how our recent survey serves as a data privacy playbook for healthcare companies, how our findings were impacted by COVID-19, and what this research means for the healthcare industry as a whole. Take a listen below.


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