Staying Healthy at Home with Telehealth

By Isadora Rodriguez-Legendre

COVID-19 has contributed to a significant shift in our health care system. It is clear that virtual care or telehealth is necessary to ensure that people stay healthy and safe at home. According to a recent study by the NH Disability and Public Health Project, the use of telehealth has increased in the last six months due to the pandemic. In New England, in particular, adults with disabilities are more likely than adults without disabilities to use remote health care visits http://bit.ly/3tjPR3e.

These changes bring newfound flexibility – as well as challenges – to people with disabilities and/or chronic health conditions as they engage with their providers. Many individuals require regular check-ins with doctors and often participate in therapies or activities that maintain or improve their health and wellness. Telehealth is a way to meet these needs by using a phone or a device with internet access. Through telehealth, individuals talk to their doctor over the phone or via video chat, send and receive medical-related messages, and have their doctor check in on them regularly.

Identifying the Pros and Cons

There are both benefits and drawbacks to receiving services through telehealth. In January, the National Association of Councils on Developmental Disabilities (NACDD) hosted a Self-Advocacy Discussion Series that focused on “The Future of Online Health care: Barriers to Access and Technology.” In this forum, people with developmental disabilities highlighted ways that telehealth has made health care easier, such as not having to worry about weather or transportation, getting appointments sooner – especially for medication refills or for filling out forms – and having access to specialists outside specific geographic locations. Some of the challenges identified included frustration in learning how to use the applications and portals, lack of internet access, and the need for communication supports or accommodations with which doctors may not be familiar.

Portals Provide Easy Access

“Having an at-home phone conversation or Zoom call with your doctor is definitely accessible for people who have a hard time with mobility, difficulty getting out of the house, or anxiety,” says John Fenley, a member of People First of NH. “My provider has a portal that you access through a secured network using a password. You can log in and see your doctor’s notes and your recent test results. It’s pretty thorough but seems a little complicated to me. I think a lot of people with disabilities might be overwhelmed because it’s somewhat difficult to navigate. I had to use the portal in order to set up a link with my doctor for a virtual meeting. People with more severe developmental disabilities might have a hard time remembering passwords or navigating the sections, and that would be challenging. Once you’re on the call though, it’s nice to just tell your doctor what’s going on, have tests ordered, and then see your test results in the portal.”

For individuals like John who require care for conditions like diabetes – especially those living in remote or rural areas – telehealth, tele-therapies, and online fitness programs have been extremely beneficial during the pandemic. This is especially true for those who may have co-occurring health conditions that would make it difficult or dangerous to go to health care facilities due to COVID-19.

John continues to work on his diabetes care during the pandemic by making his telehealth appointments, taking his medication, being more conscious about his diet, and exercising at home. He hopes that the future includes increased options for people with disabilities, like virtual access to resources, even though he recognizes that there will always be people who prefer to have in-person health care.

“People who’ve already been removed from daily life due to their disability suddenly have all these options if they have technology,” John shares. “It would be sad if suddenly they thought, ‘oh, now I can’t have my yoga class anymore because they went back to doing it in person.’”

Moving Forward

As more opportunities arise for individuals with disabilities to maintain health and wellness through telehealth, it will be important to find a balance as the pandemic subsides. It is also necessary for New Hampshire lawmakers to continue to address accessibility barriers to telehealth services, especially in rural communities, and make certain that providers are familiar with the types of supports and accommodations that people with disabilities may require. Having more options will allow people with disabilities to access health care in a person-centered way.

Isadora-Rodriguez Legendre is the Executive Director of the NH Council on Developmental Disabilities.