Virtual Care: Ensuring Access for All Patients

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HHS offers tips for avoiding discrimination against people with disabilities or limited English proficiency.


Providers and developers of technology solutions must ensure that patients with disabilities can also take advantage of virtual care offerings.

Integrating virtual care into healthcare delivery opens new doors for patient access and interactions. But some patients, especially those with disabilities or limited English proficiency, may not be able to experience the full benefits.

Developers of virtual care tools as well as clinicians using these tools should make it a priority to enable all patients to have access to virtual care.

HHS Tips

Guidelines recently released by the Department of Health and Human Services outline how to avoid unintended discrimination in the use of virtual care tools.

The objective is to recall that non-discrimination laws apply regardless of the setting in which care is provided or the modality used to provide care.

The law does not distinguish between in-person and remote care, so the same considerations should apply in both contexts.

Access for people with disabilities

In addressing people with disabilities, the HHS guidelines consider providing access to virtual care tools as well as ensuring effective communication.

HHS says people with disabilities should not be excluded from using virtual care solutions. Assuming that a disability could prevent the use of virtual care deprives these patients of the opportunities and benefits that can come from the tools.

The agency explains that, for example, a clinician should avoid, assuming that a person with an intellectual disability will not understand how to navigate the virtual care platform. Every patient should have the opportunity to use the platform, and materials or instructions should be reframed, if necessary, to ensure everyone can understand them.

HHS also responds to the need to provide reasonable accommodations or modifications to help support patient use of the tools. This could mean allowing more time before, during or after a visit or allowing the patient to have other people with them during a visit.

It all comes down to understanding the needs of each patient and working to have tools that meet those needs.

When it comes to communication, HHS guidelines focus on people with visual or hearing impairments. In either case, the integration of alternative forms of transmitting information, whether text or text-to-voice, may be necessary, the guide points out. These measures reflect what needs to happen for in-person visits.

Limited proficiency in English

The HHS guidelines also address access authorization for people who are not fluent in English.

Support for these people is an essential element in avoiding discrimination based on national origin. Promoting access means offering language assistance services. This includes, for example, the provision of written communications in more than one language as well as the provision of interpretation services.

Again, virtual care is just a different platform to deliver the same services that can be delivered in person, so the same supports need to be in place.

Equity in Virtual Care

Being aware of the need to make virtual care fully accessible to all patients requires careful consideration of how individuals may approach using a particular virtual care tool.

Moving forward without this awareness can create unintended blind spots, as a person may not have all the experiences necessary to consider the full range of care approaches.

After awareness comes intentionality. Organizations must make a long-term commitment to integrating the requirements and evolving their policies to stay compliant. These efforts can involve a significant amount of work, but the benefits are well worth it.

Delivering quality health care requires ensuring that all patients can benefit from the most appropriate services. As healthcare continues to innovate and move towards a new continuum of care, everyone should be able to benefit.


Matthew Fisher is Carium’s General Counsel. This column previously appeared on the Carium website here.

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