by Mardia A. Shands, M.A., SPHR, SHRM-SCP, Human Resources and Diversity, Equity, and Inclusion Consultant at Mardia A. Shands Consultancy LLC
 

“Mardia, get on the phone with this doctor to see if you can make this phone work. She’s calling me about my CAT scan and the telephone is not working. It keeps disconnecting.” “Okay, mom.” 10 minutes later, after multiple hang-ups, we were finally able to get the doctor on the tele-visit call and my mom had her visit with her physician. The visit was to get her scheduled for a CT scan to see why she was experiencing chest pains — a serious concern which we all held for my 71-year-old mom who lives by herself in California, 2000 miles away from my sister and I in Ohio. I couldn’t help but wonder what would have happened to that tele-visit had I not been visiting her. Would she eventually have given up and hung up the phone? Would the doctor, who likely had the standard 15 minutes to spend on that tele-visit, have eventually given up and gone on to other patients?

This is a typical scenario that is happening countless times a day to individuals across the United States. Patients who may be elderly, poor, and/or minority, oftentimes aren’t tech-savvy, nor do they have regular access to technology. Subsequently, the reality of employing technology to receive healthcare is challenging. The increasing use of technology in the delivery of care has widened the gap in the already unacceptable levels of health disparities that exist for Black, Indigenous, People of Color (BIPOC), poor and elderly people. Data continues to support that health disparities within communities of color and poor communities is a national problem. Secondarily, this digital divide for BIPOC, the poor, and the elderly is widening every day, resulting in a confluence of technology and health inequities. The use of technology to enroll individuals to be vaccinated is an example of the digital divide challenge. In fact, the lack of access to the technology, including no access to wi-fi and the complexity of the sign-up process, has resulted in people who are poor, and communities of color being left behind.

To demonstrate how widespread this phenomenon is, a New York Times article reported that people in underserved neighborhoods are being left out of vaccination programs by the convergence of obstacles including registration phone lines and websites that take hours to navigate. Furthermore, the lack of transportation and the inability to obtain time off from jobs to attend appointments is compounding the problem. The data also indicates that people from wealthier, largely white neighborhoods are flooding the vaccination appointment systems and taking an outsized share of the limited supply of vaccines. While early vaccination data is incomplete, it points to the digital divide as one of the reasons for the difference.

Organizations and systems who are responsible for providing services to diverse populations have a responsibility to develop mechanisms to meet the challenges for all people in their client base. An initial step should be to proactively consider these challenges jointly with our workforce.

What if we deployed the ingenuity of workforce development and coupled it with diversity, equity, and inclusion education to create a solution for those who need to access the healthcare system more effectively but do not have the resources nor the technological tools to do so? This revamping would come in the form of a new workforce that specializes in care coordination and has the medical, technological, and cultural competence to work with patients who are likely to be left by the wayside with the advances in healthcare technology.

Healthcare delivery settings and insurance settings should set as a priority the establishment of Medical Care Counselors to facilitate the navigation of their clients through the complexity of the system of care. While this has become more notable during the era of COVID-19, it has been recognized as a need for several decades. What has been exposed and requires more focus, is the expanded use of technology and the growing number of people who don’t have access or haven’t been exposed to its use and subsequently are not accustomed to managing their care and services through those mechanisms. So, the future healthcare workforce will need to include individuals who are able to interact effectively with a diverse population, those who are tech savvy, BIPOC, white, elderly, and poor.

To quickly add this role to an organization, one might consider the Medical Assistant (MA). The MA has the appropriate level of education and is typically an individual who has first contact with patients. Additionally, MAs are trained in the use of advanced technological equipment. Subsequently, organizations would need to be intentional in providing education and training on organizational values and beliefs related to equity and inclusion practices, as well as determine how their workforce would begin to reflect their clients. Healthcare delivery systems who are committed to closing the health disparities gap will consider becoming involved in helping their patients manage the technology challenge. It’s a great first step!

Please note: This article contains the sole views and opinions of Mardia A. Shands and does not reflect the views or opinions of Guidepoint Global, LLC (“Guidepoint”). Guidepoint is not a registered investment adviser and cannot transact business as an investment adviser or give investment advice. The information provided in this article is not intended to constitute investment advice, nor is it intended as an offer or solicitation of an offer or a recommendation to buy, hold or sell any security. Any use of this article without the express written consent of Guidepoint and Mardia A. Shands is prohibited.

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