The article "Role of nursing in telehealth" in the June issue of Nursing2022 was informative but glossed over inequities in access to telehealth. In my experience during the COVID-19 pandemic, the effect of poor internet connectivity was felt on education; children from poor households and those in rural areas were left behind. As we extoll the virtues of telehealth, conversations about access must be put up front and loud.
In real-world applications, telehealth is not all peaches and cream. I worked for an innovative company that provided online palliative care. While I was skeptical at first, I was amazed at how easy it was to develop real relationships via videoconferencing. However, I found that my view of patients via telehealth on a smartphone, for example, was truncated and nothing like what I could learn by walking through their homes and seeing what is in their cupboards, shelves, and bathrooms. Connectivity was a major problem at both the user and technology levels. Discussing a serious illness with a screen that stutters and freezes is not comforting for the patient or the clinician.
Although telehealth is a real boon for rural areas, it is often unavailable. I have a friend who is bedbound after a stroke. She lives in a mountainous region located 2 hours (and $35.00 for gas) away from her healthcare providers. It is an extreme financial, mental, and physical burden to get to appointments, so telemedicine would be perfect. However, she cannot get connected to the internet.
We have a lot of advocacy to do and a long way to go before telehealth will be available for all populations.
Lauri Rose, BSN, RN, HNB-BC
Bridgeville, Calif.