The AAMC and the AAMC Center for Health Justice submitted a letter to the White House Office of Science and Technology Policy (OSTP) on March 30 in response to a Jan. 5 Request for Information on how digital technologies are used to transform community health, individual wellness, and health equity.
This request is part of a broader OSTP-led Community Connected Health initiative, established to better understand how science and technology can increase access to quality health care by “meeting people where they are in their communities.” As noted by the OSTP, “[d]espite decades of investment in the digital health ecosystem, the COVID–19 pandemic illuminated continuing, substantial limitations in the U.S. healthcare systems, including profound disparities in healthcare and associated poorer health outcomes within certain communities. Yet the pandemic has also provided an opportunity for innovation in healthcare delivery across the U.S. and internationally, particularly in community-based settings.” The AAMC expressed appreciation for the department’s interest in advancing these critical issues and agreed that while digital technology has improved during the pandemic, it has also amplified the disparate impacts of technology on certain communities.
The AAMC Center for Health Justice has previously expressed support for the federal government’s interest in the expansion of equity-focused methods and approaches across the government, recommending the need for direct feedback from individuals and communities closest to injustice and inequity [refer to Washington Highlights, July 9, 2021]. In its response to the OSTP, the AAMC reemphasized this recommendation, suggesting that the OSTP take immediate steps to establish a role in the initiative for “‘Community Anchors,’ trusted individuals or organizations from a specific community that would help build meaningful relationships between the Federal Government and community partners.” Additional recommendations to enhance the use of digital technologies included:
- Using the AAMC Center for Health Justice Principles of Trustworthiness as a resource to facilitate communication with community stakeholders and develop strategies and new approaches to advance equity.
- Expanding telehealth waivers and flexibilities beyond the public health emergency to ensure patients continue receiving access to care. This should include the removal of Medicare’s patient location restrictions and rural site requirements to allow services to be furnished via telehealth in any geographic location (including the home), payment for audio-only services, and reimbursement of telehealth services at the same level as an in-person visit to support necessary infrastructure.
- Facilitating interagency coordination by sharing the feedback received from this RFI, in addition to aligning the work of the initiative with departments and agencies working on health technology issues, including: the impact of structural bias in machine learning algorithms, electronic health record interoperability and standardization of data elements across systems, funding for community-based organizations, and the incorporation of the patient experience in the design and development of health technology (e.g., increase ease of usability across populations).