How to boost healthcare access and equity for all
July 5, 2022
July 5, 2022
Healthcare is evolving fast. Around the world, we’re seeing communities adopt a hybrid health and care model, using a combination of in-person and virtual delivery to ensure continuity of service. But to cement this hybrid model within mainstream healthcare—to increase access to care and achieve equity for everyone—will require comprehensive actions at the government policy level.
In early June, at the HealthTech Summit in Kigali Rwanda, the Broadband Commission’s Virtual Health and Care Working Group released its report “The Future of Virtual Health and Care: Driving access and equity through inclusive policies.” Co-chaired by Dr. Tedros Adhanom-Ghebreyesus (Director General of World Health Organization) and Dr. Ann Aerts (Head of Novartis Foundation), the working group partnered with Accenture to report on market developments and current virtual health policies across 23 countries. The report presents a policy framework and key recommendations with the goal of enhancing the maturity of virtual health and care.
I was proud to lead the Accenture Development Partnerships team on this engagement. I see virtual health and care having an incredibly positive impact on people’s lives. It lets patients and providers engage continuously and is a terrific way to overcome space and time constraints. Through our work, we are hoping to advocate for its scale in a globally inclusive way.
The COVID-19 pandemic has been a big catalyst for change in the delivery of healthcare. Because of the need for physical distancing, public and private healthcare providers have had to adapt, offering virtual delivery to plug gaps in the continuum of care. In the report, we provide several examples. For instance, Aarogya Setu, a contact tracing app in India, had 190 million downloads within a year. And the UK’s National Health Service saw an increase of 1 million weekly physician appointments between 2020 and 2021 through its NHS Pathways triage and clinical decision support system.
Throughout our research, we found that patients and healthcare providers have embraced virtual health and care. In the US, the proportion of telehealth claims out of total health claims is 25 times higher than pre-COVID, whereas in India, teleconsultations through the eSanjeevani platform are four times higher than in October 2020. Furthermore, compared to what it was pre-COVID-19, the expected average compound annual growth rate of the global telemedicine market between 2019–2025 increased by seven percentage points to 21.8%.
In addition to its growth in adoption, virtual health and care has, in some instances, translated into greater equity. For instance, when we looked at the impact of virtual care based on gender, we saw that although women are less likely to have access to the internet and digital technologies than men, special programs in some countries have helped to mitigate this gap. In Uganda, FamilyConnect is expanding the traditional target audience for maternal and child health by sending targeted SMS messages not only to expecting and new mothers, but also to male partners and caregivers.
We’ve also seen rural populations have less access to broadband connectivity than urban residents. In India, My TeleDoc helps to get around this by remotely connecting healthcare workers to clinicians over low bandwidth connections. People with disabilities are also frequently left out of digital society. But in the United Arab Emirates, Sanad Card is helping people with disabilities access specialized health services such as electronic nursing surveillance and home medical consultations.
We have also seen policy related to virtual health and care develop at an unprecedented scale and pace, which is helping to drive the uptake of virtual delivery and overcome equity issues. For instance, since the COVID-19 pandemic began, several US states have revised their health provider licensing policies to enable virtual care delivery across state borders. Also, New Zealand has developed a targeted strategy to integrate the needs of people with disabilities and minority groups to support equitable health and care. Rwanda, on the other hand, has expanded its community-based health insurance scheme to include virtual health and care delivery.
In the report, we outline 15 essential elements to guide policymaking of virtual health and care, developed through 23 country case studies and 80+ stakeholder interviews. Some of the key areas are noted below, but I highly recommend reading the report for the full list.
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We categorized these essential elements into six policy pillars that form a framework to guide policymakers actions going forward.
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The working group calls on policymakers globally to integrate virtual delivery into their respective national health plans. Using this framework and the roadmap outlined in the report, policymakers should be able to develop inclusive policies that drive maturity in virtual health and care.
But the working group recognizes that policymakers alone cannot advance virtual health and care in an inclusive way, so it proposes complementary actions for other key stakeholders, including healthcare providers, payers, INGOs, and beyond. While the table below offers an overview of key actions for different stakeholder groups, I recommend reading the full report to understand how collective action can complement the activities of policymakers.
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After conducting more than 80 interviews with external subject matter experts, it’s clear to me that combining virtual and in-person health and care offers benefits across the board. It can make care more accessible to people who might not be able to attend a clinic in person, whether they have mobility issues or live in a remote community or for some other reason. And it means healthcare providers can offer care to a wider range of patients.
However, we need policymakers and other stakeholders to support and enable the addition of virtual care into existing health and care programs to help ensure last mile coverage. For me, the big takeaway of the report is the critical role of inclusive policymaking. Policies are truly the glue that binds it all together— helping to close equity gaps in health and care access and outcomes and achieve universal health coverage.
I highly recommend that you read the full report: The Future of Virtual Health and Care: Driving access and equity through inclusive policies. Or check out the Executive Summary for an overview.