Berkeley Conversations: COVID-19: Digital and telehealth implications of COVID-19 and social distancing

Mirroring the dramatic uptick in digital interaction, University of California-affiliated health centers have seen a 1000% increase in telehealth since the beginning of the pandemic, UC Berkeley health experts said.

During Tuesday’s live, online Berkeley Conversations: COVID-19, a group discussion moderated by CITRIS Health Director David Lindeman wondered, how we can leverage technology to reach people in need during social distancing? And what are the challenges of reaching under-resourced communities with lower digital literacy?

In the discussion, Adrian Aguilera, of UC Berkeley’s School Social of Welfare and UCSF; Courtney Lyles, of UCSF and Berkeley’s School of Public Health; Elaine Khoong of UCSF; and Heather Ladov, of La Clinica de la Raza, offered a firsthand look at the barriers and opportunities of digital health care.

“The pandemic has really shone a light on some of the digital equity issues that we have in our country,” said Lyles.

Many of Ladov’s and Khoong’s patients were reluctant to use video, finding phone consultations easier. Technical challenges were amplified with older patients and with children. Lack of privacy was a concern for those sheltering in small spaces with multiple family members or roommates.

Other obstacles stem directly from healthcare systems. The speed of the shift to remote care means that healthcare workflows, billing practices and policies are still catching up to the new normal of care during the pandemic.

In some cases, the panelists said, technology lowers barriers.

Aguilera’s previous research has shown that automated text messaging increases patient engagement with cognitive behavioral therapy for depression and improves diabetes management.

Khoong shared the example of a patient whose reliance on supplemental oxygen made it difficult for the patient to leave the house. With remote appointments, the patient’s access to care actually improvedPatients with mobility limitations or caregiving responsibilities — or even those who would otherwise have to drive across town for an appointment — may find it easier to access care remotely.

The panelists agreed that telehealth is here to stay. The challenge, they said, will be to identify the populations that are best served by remote care, and to expand access in a way that does not exacerbate existing disparities.

“We need to innovate with and for those with the highest need. We need to start with the basics,” Aguilera said. “We need to provide access to high-speed internet. We need to provide training and tutorials. It’s not enough to throw our hands up and say ‘this isn’t possible.’ We have to find ways to do it.”

Berkeley Conversations: COVID-19 is a live, online series featuring faculty experts from across the Berkeley campus who are sharing what they know, and what they are learning, about the pandemic. All conversations are recorded and available for viewing at any time on the Berkeley Conversations website.