Telemedicine and Vulnerable Populations | Telemedicine and e-Health

While the concept and application of telemedicine and telehealth have been around for a century or more, it really did not become common place until recently, although it has been in use for the past 60 years or so. In 1950s Nebraska it served as a tool for addressing mental health conditions across the state.¹ In the build up to NASA’s Skylab program in the early 1970s, the Space Technology Applied to Rural Papago Advanced Health Care (STARPAHC) integrated advanced medical and communications technology on the Papago Indian Reservation in southern Arizona.² In addition to these two, there are many early examples of how telemedicine and telehealth have been applied to vulnerable populations.

Vulnerable populations can be categorized into three domains: physical, psychological, and social.^3–5 There are many factors that are challenges and barriers in these domains. Access and cost can be significant barriers. However, other salient issues, including race, ethnicity, sexual orientation, culture, and language, can serve as significant gauntlets to care as well.⁶ The current ongoing pandemic and subsequent distribution and administration of approximately 3.5 billion vaccines worldwide have been uneven across our communities and nations. Those who are more vulnerable as a community or nations that have limited resources—financial or technological resources as well as poor leadership—remain vulnerable. Geography and weather are also making more people vulnerable. Consider the triple digit heat wave in the American west or the rising sea levels!

Enhancements in care for vulnerable populations have been brought about by telemedicine and telehealth. The technologies used in applying telemedicine and telehealth have enabled an increase in access to health care and awareness of tools to help individuals manage their health.

In late 2020, the California Health Care Foundation (CHCF) approached our publisher about sponsoring a special issue on telemedicine and vulnerable populations. A call was sent out worldwide and the response was robust. Through the CHCF’s generous support, there was a significant number of responses from around the world. Articles were submitted from COVID-19 hotspots such as New York and other states, including Arizona, California, Connecticut, Florida, Hawaii, Iowa, Maryland, Massachusetts, Michigan, New Mexico, North Carolina, Pennsylvania, Oregon, Texas, South Carolina, Virginia, and Washington, and several countries, including Brazil, Canada, China, Colombia, Denmark, India, Italy, and Morocco.

Each submitted article was subjected to vigorous peer review, which resulted in the 17 articles, which are published here. The majority (11) are focused on COVID-19 and the others focused on a review of technologies and processes. The importance of these articles and others that have been published in the past 18 months or so is that the number of participants or encounters has grown exponentially. Although an n of 100 can tell us something of importance, it is when the numbers get into the 10s of 1000s, now the impact and significance become extremely important to our field.

Telemedicine and telehealth have provided access where it was not available before or was, at least, limited. As the landscape of health care and the fabric of our society continue to evolve, the lessons learned and capabilities reported here will serve as a catalyst for change, whereby those less fortunate will have equal access. The paradigm shift we are observing will eliminate barriers and reduce vulnerabilities for all.

On behalf of CHCF and the journal, I hope you find this special issue of interest and compelling. It is slightly larger than most, but you will it find full of excellent work from around the world.

The only way forward is through collaboration and embracing change!

Journal News

As a result of the rapid integration and adoption of telemedicine and telehealth, the impact factor for Telemedicine and e-Health grew by 48% over the past year. For the reporting year 2020, it stands at 3.536 and the cite score has increased from 4.2 to 4.6. These metrics measure the success and reach of the journal. Articles accepted for publication will be published online and citable much faster than when they appear in print. This step permits more material to support your effort.