Viewpoint: Telehealth Disparities Exist Among Visually Impaired Populations

A new piece published in Health Affairs explained that despite the massive expansion in virtual care, telehealth disparities remain among those with visual impairments (VI), and solutions that can help support these patients have yet to be created.

In the last several years, the expansion of telehealth has helped countless people with their healthcare needs. Article authors noted that telehealth has the potential to minimize issues related to access, transportation, and exposure to COVID-19.

Providers and payers have turned to virtual care capabilities to improve care and access to services. For example, Blue Cross Blue Shield of Michigan recently added a service to enhance virtual maternity care.

However, these benefits have had certain downsides, as many populations have experienced telehealth disparities. There have been some efforts to diminish this issue, for example, the expansion of services supported by the CARES Act. Nonetheless, various populations remain underserved, including those with VI.

Holding a place in the list of top 10 causes of disability among US adults, VI patients often struggle to obtain needed care, especially through telehealth. This is largely due to trouble with navigating telehealth platforms, as many are not created with accessibility-based design and lack key tools, such as screen readers and magnification.

The authors provided various recommendations to help improve virtual care for the 7.08 million Americans with visual acuity loss and the 1.08 million Americans who are blind.

Their recommendations included considering the various types of assistive technology that are available, such as smartphones, tablets, and laptops. Also, when caring for VI patients, high-contrast features are critical, they noted.

In addition to providing resources to improve the daily lives of these patients, the authors stated that providers could work in advance to address technical issues. For example, staff members can test equipment and internet connections before the telehealth visit. They also stated that patient education on virtual care services being implemented is critical. Still, these, too, must be provided in an accessible way, such as via braille or audio recordings.

Further, the authors said that improving telehealth accessibility, bolstering clinical transformation, and continuous quality improvement are necessary to implement these recommendations into clinical practice.

Previous studies have examined the methods used to implement technology into treatment for those with VI and how they can be improved.

A study published in April found that artificial intelligence can assist VI patients with navigating the healthcare system. Current computer vision technology, such as remote sighted assistance (RSA), poses barriers, researchers noted. For example, RSA aims to assist VI patients by connecting them with a human agent via smartphones, but the limitations of the technology prevent agents from fully supporting those with VI.

Researchers found that using AI alongside human agents could improve the user experience for people with VI.