ABSTRACT

In the U.S., those who lack broadband internet have limited ability to connect to care providers over a telemedicine video visit (VV). During the coronavirus disease pandemic, VVs have become increasingly common, but are not equitably accessible, which may exacerbate existing health disparities. Widening health disparities are of particular concern in the rural U.S. where broadband is lacking. Because public libraries are trusted sources of health information and typically offer free use of broadband internet to patrons, they can help bridge the digital health divide and assist patrons with VVs. However, no guidelines currently exist for care providers and libraries to implement this potentially complex undertaking. In this paper, we review concepts related to the digital health divide and its impact on telemedicine inequities, and propose a research framework for evaluating public libraries as potential hubs for residents living in broadband-poor communities to connect to a telemedicine VV. There is currently a paucity of research evaluating the use of libraries for telemedicine, although partnerships between libraries and health providers may be increasing. We use an established health implementation science framework to guide a research agenda to examine the reach, efficacy, adoption, implementation, and maintenance of collaborative programs between libraries and health providers intended to leverage public libraries to improve access to telemedicine VVs in broadband-poor communities. The use of public libraries as spaces from which patrons can participate in VVs with providers is promising, but research is urgently needed to guide implementation.

摘要

在美国，那些缺乏宽带互联网的人通过远程医疗视频访问 (VV) 连接到护理提供者的能力有限。在冠状病毒病大流行期间，VV 变得越来越普遍，但并不公平，这可能会加剧现有的健康差距。在缺乏宽带的美国农村地区，日益扩大的健康差距尤其令人担忧。由于公共图书馆是值得信赖的健康信息来源，通常为顾客免费使用宽带互联网，它们可以帮助弥合数字健康鸿沟并帮助顾客使用 VV。然而，目前没有针对护理提供者和图书馆实施这一潜在复杂任务的指南。在本文中，我们回顾了与数字健康鸿沟相关的概念及其对远程医疗不平等的影响，并提出一个研究框架，用于评估公共图书馆作为宽带贫困社区居民连接远程医疗 VV 的潜在枢纽。目前很少有研究评估图书馆在远程医疗中的使用，尽管图书馆和医疗服务提供者之间的合作伙伴关系可能正在增加。我们使用已建立的健康实施科学框架来指导研究议程，以检查图书馆和健康提供者之间的合作计划的范围、有效性、采用、实施和维护，旨在利用公共图书馆改善宽带贫困社区对远程医疗 VV 的访问. 使用公共图书馆作为顾客可以与提供者一起参与 VV 的空间是有希望的，但迫切需要研究来指导实施。