Social Workers Can Expand Telehealth Access for Stroke Survivors

Published in Stroke, details from a review conducted by UTHealth Houston described that many stroke survivors benefit from telehealth, with options such as community health workers, mobile hotspots, and smartphone applications among the various options for those with limited internet access or digital literacy.

According to Anjail Sharrief, MD, first author and associate professor of neurology with McGovern Medical School at UTHealth Houston, using telehealth to treat chronic conditions has grown in recent years. Despite this growth, information surrounding telehealth-related disparities among stroke survivors remains understudied.

A stroke occurs among 795,000 people in the US exhibit annually, according to the Centers for Disease Control and Prevention (CDC). Further, one in six deaths from cardiovascular disease resulted from a stroke in 2020.

“As we begin to advance the use of telehealth in stroke and in chronic diseases in general, we must consider the potential advantages and barriers to use in populations at highest risk for disparities,” said Sharrief, who is also director of stroke prevention at the UTHealth Houston Institute of Stroke and Cerebrovascular Disease and director of the Stroke Transitions Education and Prevention (STEP) clinical program, in a press release.

Sharrief and a group of researchers initially noted that complications such as impaired gait, vision, and cognition are issues that can be treated via telehealth. Additionally, telehealth can help mitigate certain social determinants of health, such as economic instability, geographic location, and limited social support.

However, telehealth can also widen health equity gaps as telehealth access varies among various populations.

“While telehealth can expand access to care and treatment in many ways, it also has potential to increase disparities in populations with lower levels of digital literacy, limited access to internet, and in whom physical and cognitive limitations pose barriers to telehealth utilization,” continued Sharrief.

To address these issues and expand access to those who may not easily benefit from telehealth, the group of researchers noted various options. These include engaging social workers or community health workers to connect patients to federal programs that provide discounts for internet access or technology, as well as the use of mobile hotspots, telehealth outposts, and cellular devices. Other options include increased use of text messaging, digital tools for patients with limited literacy or impairments, broader digital literacy training, and digital health navigators.

“Several of the listed recommendation[s] have shown promise for improving telehealth access and utilization in other chronic disease populations,” said Sharrief. “My group and co-authors on the manuscript are testing these in the stroke population.”

Aside from this, the authors noted their recommendation for developing telehealth tools and including family members to assist those with hemiparesis or incoordination due to a stroke.

Previous research has indicated various benefits that telehealth provides for stroke survivors.

In February 2022, research showed that telehealth and remote patient monitoring led to improved engagement rates and blood pressure control among stroke survivors in under-resourced communities.

Researchers drew this conclusion following a study that involved stroke survivors of various ethnicities, levels of education, and insurance statuses. All patients received care through either a traditional method or a Telehealth After Stroke Care strategy that included mobile tablets and blood pressure monitors. Researchers found that the Telehealth After Stroke Care group had higher patient engagement rates and better blood pressure control.