Lack of broadband access is a barrier to healthcare – and Michigan aims to eliminate it

This article is part of Health, a series on how Michigan communities are rising to meet health challenges. It is made possible by funding from the Michigan Health Endowment Fund.

When the COVID-19 pandemic struck, healthcare moved to online modality virtually overnight – and with admirable results. Telehealth has helped Michiganders access needed care, and it will likely remain a common, convenient, and cost-effective way to connect with providers even after the pandemic is over.

However, when COVID-19 moved supplier appointments – and many other things in life – online, it became clear just how deep Michigan’s digital divide has become. According to the Federal Communications Commission, over 1.2 million homes in Michigan struggle with internet connectivity. Gaps in high-speed Internet access have a disproportionate impact on Michigan’s communities of color, those in rural areas, and low-income households.

Michigan’s largest federally licensed health center, Cherry Health provides integrated health services to residents of six counties in southwest Michigan. Some live in low-income urban neighborhoods, while others live in rural areas. Because many of them encountered obstacles in meeting face-to-face appointments, Cherry Health launched telemedicine programs before the pandemic and dramatically increased their use when COVID-19 hit.

At the height of pandemic stay-at-home orders, Cherry Health providers provided virtually over 80% of all care. While those numbers have fallen to 30% in 2021, the lack of access to modalities online is having a real impact on the people Cherry Health serves.

“Many of our patients have barriers to entering our office – transportation issues, childcare, absence from work – so it certainly saves time and is more convenient for people than entering the office,” explains Dr. Leslie Pelkey, Chief Cherry Health physician. “… We have found that this is a great way to monitor people for minor health issues like cold-like symptoms or rashes, and it works well for tracking certain chronic conditions. . And, of course, behavioral health issues adapt well to telemedicine. “

Pelkey ​​describes virtual tours as taking two forms: video and audio. Video visits create a real window into the patient’s home. Providers can ask patients to open their medicine cabinets and refrigerators to assess potential drug conflicts or food insecurity. A glance inside the home can identify hazards like area rugs that could trip and fall an elderly person.

However, an assessment of data from Cherry Health found that while 30% of this year’s care took place virtually, 68% of those visits were audio-only. Patients reported that barriers to accessing video tours included not having smart devices, lack of broadband connection and, especially in older patients, digital illiteracy.

“With his [only]it is much more difficult to assess any type of physical problem, ”explains Pelkey. “Is the patient pale and lying in bed with his blankets pulled up to his chin, or smiling with great energy and able to get up and move around?” After the launch of our telehealth platform, we were quickly alerted to the tremendous disparity in the care of patients without access to video.

Paula Cunningham, AARP MichiganThe state director of, said COVID-19 “has opened the eyes of so many” to the many barriers many Michigan residents face in staying healthy – and how access broadband can eliminate them.

“The main barriers to accessing telehealth are: one, not having a broadband service provider; and the other, not knowing how to use it, ”she said.
Paula Cunningham.
Cunningham notes that when older people do not have access to broadband, they are also at a higher risk of experiencing social isolation, which in itself puts people in danger for many physical and mental health issues, including heart disease, diabetes, anxiety, depression, and premature death – and medicare is estimated to cost a cumulative additional $ 6.7 billion each year . Cunningham notes that broadband-enabled devices also make home health care a more viable option.

“Accessing health care outside the home can be very difficult for the elderly and people with disabilities,” she says. “It can be very difficult to get to medical appointments, get their prescriptions, or even get to the store. With broadband access, they can even shop online.

Bridging the digital divide

Help is on the way for the Michiganders for whom broadband access is a barrier to good health. AARP Michigan is launching programs to help train seniors to use their devices and get the most out of their online communities. And meanwhile, the state of Michigan is working to ensure that everyone in Michigan can access the health care and other services they need online. Michigan Governor Gretchen Whitmer created the June 2 Michigan High Speed ​​Internet Office (MIHI) to bridge the digital divide by making high-speed Internet more affordable and accessible.
Garlin Gilchrist.
Based within the Michigan Department of Labor and Economic Opportunity (LEO), MIHI’s mission is to develop strategies and coordinate funding to ensure that every home and business in Michigan has access to a reliable and affordable broadband connection. ; smart devices; and the skills to use them.

“The goal of our administration is to ensure that everyone in all parts of Michigan has full access to the health services they need and that they are able to be healthier and better. of its form, ”said Michigan Lt. Gov. Garlin Gilchrist. “A high-quality high-speed Internet connection at home will contribute to better health outcomes. “

For example, accessing care through a smart device has been particularly helpful for those managing chronic illnesses and connecting with mental health care providers during the pandemic.

“If you are a Michigander living with SLA, there are a small number of ALS treatment and care centers in the state of Michigan, but there are none in the Upper Peninsula, ”says Gilchrist. “If you live in the Upper Peninsula, it’s very difficult to take a trip to any of these centers in lower Michigan. If, instead, you could meet this specialist through a telemedicine experience, you would only have to take this trip to Lower Michigan twice a year instead of six, seven, or eight times. This level of accessibility can be a game-changer for people of all walks of life. “
Susan Corbin.
According to Susan Corbin, Acting Director of LEO, having MIHI as the access point for Internet providers, local communities and households will facilitate the expansion of broadband access. When the U.S. stimulus package and other federal programs release money for broadband to states, Michigan will be ready to direct it where it’s needed most.

“During the pandemic, we realized how essential it is for every household to have strong connectivity. Ours, [lack of access to] it’s a barrier that needs to be removed, ”says Corbin. “Having broadband access is one of the barrier removal issues we’re talking about. Access to broadband means better housing, options for healthy diets, medications and other social determinants of health for a household. We believe that having access to the Internet improves the quality of life.

Telemedicine isn’t going to go away, but increasing access to broadband and smart devices is an important tool in reducing health care disparities in Michigan.

“Providing universal and affordable Internet access would help reduce this marked disparity in access to digital health care,” said Pelkey. “This would be a big step forward, not only to support telemedicine, but is also essential for education and employment, which are important social determinants of health and also have an impact on health equity. . “

A freelance writer and writer Estelle Slootmaker is happiest writing about social justice, wellness and the arts. She is the editor-in-chief of development news for Fast growing medium and L’Arbre Amigos chairs, Wyoming City Tree Commission. His greatest achievement is his five incredible adult children. You can contact Estelle at [email protected] Where

Photos of Dr Leslie Pelkey ​​by Bud Kibby. Photos of Paula Cunningham by Roxanne Frith. All other photos courtesy of the subject.

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