RHITES on Bridging Gaps in Telehealth - Building for Digital Equity Podcast Episode 22

Sean Gonsalves (00:06):
This is the Building for Digital Equity Podcast where you'll hear from those working on the front lines to expand Internet access, address affordability, and help provide the digital skills and devices necessary to participate in a digital world. This show comes to you from the Community Broadband Networks team at the Institute for Local Self-Reliance. [00:00:30] Here you'll find short interviews with digital inclusion practitioners from across the nation, highlighting the work and inspirational stories to ensure everyone has access to high-speed Internet. Now let's see who we have today.

Jordan Pittman (00:52):
So my name is Jordan Pittman and I'm here with the RHITES team today, which I'm so honored to be a part of today. Thank you guys for [00:01:00] having time today to come by and speak to y'all about the organization y'all run and things y'all do. Could y'all start by just doing introductions and letting the audience know who you are?

Dana Northcraft (01:09):
Sure. Hi, I'm Dana Northcraft. I'm the founding director of RHITES, which stands for the Reproductive Health Initiative for Telehealth Equity and Solutions. I use she/her pronouns and we're really excited to be here. Thanks, Jordan. I'll kick it to Natalie.

Natalie Birnbaum (01:24):
Thanks, Jordan. My name is Natalie Birnbaum. I am the state legal and policy director over at [00:01:30] RHITES, and I'm also very excited to be here and chat with you about our intersection with broadband connectivity and I'll pass it over to Emily.

Emily Schacter (01:39):
Hi everyone. Thanks so much. I'm Emily Schacter. I use she/her pronouns. I'm the senior program manager at RHITES, echoing the others. We're thrilled to be here, big fans of Digital Equity and NDIA more generally, so thanks Jordan.

Jordan Pittman (01:52):
No, thank you guys. Funny story, Natalie actually reached out to me just to like, Hey, can I be on the podcast? [00:02:00] But she did that right after the live stream a couple months ago and it just fell through the cracks and I was like, oh, I didn't see it until a couple weeks later and I felt like the most horrible person in the world. I was like, Natalie, I'm so sorry. So I'm so glad we were just able to finally get this together and I apologize about the delay. So I just want to go straight into, because I'm so excited about this, can y'all just talk a little bit about what the organization is and kind of the goals that y'all try to accomplish and the work you guys do? Sure.

Dana Northcraft (02:27):
So hi everyone. Thanks for joining and listening [00:02:30] into the podcast. So with RHITES, we believe in fostering innovation and bridging equity gaps in telehealth by integrating reproductive and sexual healthcare into the larger healthcare system. And we develop and distribute resources, convene people and organizations, and share knowledge across the telehealth and reproductive health rights and justice communities to advance access to sexual and reproductive healthcare via telehealth. As it comes to the intersection with broadband, I'm sure a lot of people [00:03:00] are very familiar with the availability of telehealth to be used to meet medical needs, especially post covid. And this is especially important related to reproductive healthcare. As I'm sure most of your listeners are aware, there's an increasing number of maternity care deserts, reproductive healthcare deserts, which leads to the increasing maternal mortality crisis that we're in. And we know that expanded broadband access will not only impact rural communities that don't have access to broadband, but also urban communities [00:03:30] where broadband and Wi-Fi can be prohibitively expensive for people to use. And the vision of telehealth is to really decrease inequities in healthcare. And one of the ways that we can reduce disparities is to expand broadband access.

Jordan Pittman (03:47):
And I completely agree on the sense of telehealth being that gap for a lot of people when it comes to connecting to broadband. Because if we think about it in the [00:04:00] grand scheme of things, right, you think about how everybody needs healthcare, everybody needs to be healthy, everybody needs to be understanding. And basically since Covid, there's been this emphasis, especially with people in rural places that you mentioned of making sure people are connected so they can get to the place they need to be in terms of healthcare or their jobs or wherever the case may be. So funny enough, and I can actually share the link with you guys as well, and I think the audience is probably aware of it as well, but we actually did a report [00:04:30] with the Southern Rural Black Women Initiative about the impacts of telehealth in 10 black belt counties inside Alabama, Georgia, Mississippi.

(04:40):
And what we found is the increase of telehealth and broadband access for these communities actually saved the counties close to $45 million based off just not having to go to emergency visits as often because they got checkups, weekly checkups with their doctor online or just the fact that [00:05:00] just being able to check in on an obvious day-to-day basis really made a huge impact. So I really wanted you guys to come on here today, really talk about this and emphasize it because healthcare can be such an impact for a lot of people and it's actually been an impact for me as well. I've actually worked in the healthcare industry before kind of highlighting and seeing how just even just a call or a video call a day can be a difference between somebody going into the emergency room or not.

Natalie Birnbaum (05:26):
Yeah, I mean it's such a great point, and particularly when [00:05:30] we're talking about reproductive healthcare and abortion care, what we've seen in the post dos landscape is many healthcare providers who are OBGYNs or offer reproductive healthcare or abortion services leaving those states or OBGYN and maternal healthcare units closing in areas that already were maternal healthcare deserts or general healthcare deserts. Now residents have [00:06:00] even fewer local access points to doctors and clinicians that offer not only abortion care, but reproductive healthcare services. And while of course, telehealth isn't the solution and something that is in place of, in-person services, telehealth can really help support patients who need access to an expert or a clinician that offers reproductive healthcare or [00:06:30] abortion services. And actually now recent statistics from the Society for Family Planning came out that share that 19% of all abortions in the United States are now happening using telehealth for medication abortion services.

(06:51):
And that means like, okay, well, how are we making sure that the people that have the most limited access [00:07:00] because of state restrictions to reproductive healthcare services, to abortion care can utilize and take advantage of telehealth in order to get the care that they need? And a lot of that comes down to something as simple as what a lot of people, including myself, I'm in New York, I have a cell phone data plan works perfectly fine. It's not a concern for me personally. And I understand that it's not so simple that everybody just has [00:07:30] access to broadband and the data that they need in order to have a functioning face-to-face encounter with a provider or a phone call with a provider to get those healthcare needs met.

Jordan Pittman (07:45):
Right. And you bring up such a crucial point where some people, a lot of people will say, Internet, why does that even matter? I got my cell phone. My cell phone's fine. I got a connection. And even for people who have a connection with their cellular device, [00:08:00] I can't use my hotspot to do this call with you guys right now. There's a emphasis on making sure that not only that everybody, I mean everybody has Internet access, but affordable and fast as well, so people can actually have the tools they need to be as successful as possible. And that's including telehealth, which y'all bring up a good point with everything you just mentioned in the sense that I think for some people, [00:08:30] they think that, let's just say the organization you guys run, I don't think an average person will call you guys digital navigators or people who work at a library is like, y'all guys aren't digital navigators.

(08:43):
But the reality is, you guys are, you guys probably work to make sure people get connected and the importance of it. You highlight it through, I think, Emily, you mentioned fact sheets and stuff you guys do. These are the type of things that indirectly you don't think about the impact that you make. But the reality is we're all kind of connected [00:09:00] to this web as we get more acclimated and more onto the Internet. So I actually wanted to ask you guys, do y'all guys consider y'all sales digital navigators? Does anybody come up to you? It's like, Hey, thank you for helping broadband. Do y'all push for that on the policy side to make sure people have Internet so they actually can do these telehealth services that y'all mentioned?

Dana Northcraft (09:20):
Yeah. RHITES works with advocates to provide resources and to educate around equity issues related to telehealth and reproductive health [00:09:30] care. And part of that is broadband access.

Emily Schacter (09:34):
I think such a core part of what we do is recognizing that there are intersectional barriers here when it comes to benefiting from telehealth for sexual and reproductive healthcare. And so digital equity is a key part of that, as is language access. If someone wants to use telehealth, but English is not their first language, for example, or they have limited [00:10:00] English proficiency, are there other languages available? Does their Wi-Fi work, can they do a video call if they want to, or is their data plan not strong enough for that? Is there reproductive health service, potentially abortion care covered by Medicaid? If not, can they afford out of pocket? There's so many compounding barriers that we try to highlight through education so that people doing this work at the state and federal level have [00:10:30] a better understanding of what needs to move forward policy wise to create more equitable landscapes out there for folks who want to use telehealth for sexual and reproductive healthcare.

(10:41):
And certainly telehealth is not a silver bullet and RHITES does not claim to say it's going to solve everything, but anyone who wants to be able to use telehealth should be able to use it. And I think we saw the use case for it really advanced during [00:11:00] the pandemic. And so now I don't think anyone can say it's not here to stay. Certainly it's here to stay. And what we're trying to really show people is that there are still gaps remaining and every single state, every community has room for improvement. And so we're there to really try to provide education and opportunity to make those advancements.

Jordan Pittman (11:22):
And that's so awesome in the sense that I know there's probably some people in the audience, including myself, so if I were to call you guys [00:11:30] right now and say, Hey, RHITES, I am just curious about telehealth when it comes to reproductive rights, how would that process be? Can I just call you guys up and ask questions about this? Would you support me in trying to be like, Hey, I don't know my nearest healthcare spot to where I can have these questions answered? Can you help me with this? I'm just very curious on what kind of assistance you guys have for just an average person.

Dana Northcraft (11:55):
Well, we are not patient focused. We do have resources on our website [00:12:00] that people who are seeking telehealth services can go to a website where they can find services that are available. We are certainly very interested in talking with folks who want to advocate in their states for digital equity and expanded access. I think one of the things that a lot of folks don't realize about telehealth is that there's this general tenant about deferring to clinical indication, deferring to what appropriate care is [00:12:30] and letting clinicians and patients make decisions that are best for themselves. And oftentimes reproductive healthcare and in particular, abortion gets treated differently and there are very many medically unnecessary restrictions that are put in place all the way from abortion bans to telehealth bans in-person requirements that have no basis in appropriate medical care that are being passed by legislators. And so it's really important, it's a goal of ours to lift those equity issues and to lift [00:13:00] how the impact of these restrictive policies on especially people of color and those struggling to make ends meet in order to create an equitable environment for care or a more equitable environment. As Emily said, it's not a panacea, it's not going to solve every issue, but we certainly need to pay attention centering equity in all policy changes.

Natalie Birnbaum (13:21):
And I'll just add to your question in case there are any listeners out there that are potential patients, a great resource to find a place [00:13:30] or where you can get telehealth for medication abortion services is the website Plan C or abortion finder?

Dana Northcraft (13:38):
I think it's plan c pills.org.

Natalie Birnbaum (13:41):
Yeah. Good correction. Thank you.

Jordan Pittman (13:43):
I think that's kind of the core of what we're talking about today or the work you guys are doing. The work we're doing personally and with our team, I think it's understanding that we're not going to be able to solve everything in one day. There's huge structural, systemic things that play that [00:14:00] are maybe causing some of these issues to be here currently. I think I always like to say if the people who say they care about it, like the big institutions say like, Hey, we need to fix these issues, more than likely, they probably already would've fixed it if they actually really wanted to do it. So I think there's an important understanding that we have to put a little pressure on them and 'em know like, Hey, these things are something that people care about. These are things that we need to highlight. And this is one of those many things [00:14:30] that that's why I wanted you guys on here today to talk about the importance of telehealth.

(14:34):
But people use this. This has been statistically shown from what you guys have done for what we've done reports on that telehealth saves lives and saves money, and it really makes a difference and it's not going away. So I think the important thing we to understand is if it's not going away, that it's only fair. That is a human right, that people have Internet access that's fast, affordable, reliable, and they're able to use [00:15:00] it at a minute's notice. So is there any lasting thoughts that you want to share with the audience before we wrap up?

Dana Northcraft (15:06):
Just I completely agree with you. Thanks for having us. And yeah, broadband access should be treated like an utility, like electricity and water. We're so dependent on it. And to restrict further restrict broadband access or fail to expand is going to exacerbate inequities. So it's not just a convenience or luxury. It really is a human right at [00:15:30] this point.

Emily Schacter (15:32):
Absolutely. And I'll just say for listeners who want to get involved with RHITES, one amazing opportunity is that we will be developing a fact sheet and then using that to host a webinar on digital equity and telehealth as it relates to sexual and reproductive healthcare. So if you're interested on working on that with us on co-branding it, you can email info@RHITES.org, that's info@rhites.org, [00:16:00] and we'd love to work with you.

Dana Northcraft (16:01):
And if anybody's interested in signing up for our newsletter, we have a quarterly one that comes out, and you can go to our website, RHITES, R-H-I-T-E-S.org and sign up for our newsletter or email the info at RHITES email that Emily just stated.

Jordan Pittman (16:18):
Guys, thank you so much for interviewing and taking time with me today to come talk with me. RHITES, I really appreciate truly the work you guys do. It's highlighting stuff that is not only just [00:16:30] important for me, but for a lot of people in this country. So I just want to say from the bottom of my heart, continue the great work you guys are doing, and if you ever need anything, we're here.

Dana Northcraft (16:39):
Great. Thanks so much, Jordan. Thank you

Emily Schacter (16:41):
For having

Dana Northcraft (16:42):
Us. We're so proud of the work you're doing too. And as you said before the interview, yes, so many of these issues intersect and it's important that we all work and band together to achieve a more equitable healthcare system in society.

Jordan Pittman (16:56):
Absolutely. If we're going to get through it, we got to do it together, right?

Dana Northcraft (16:59):
That's right.

Jordan Pittman (17:00):
[00:17:00] Awesome. Thank you guys.

Dana Northcraft (17:03):
Thank you.

Sean Gonsalves (17:04):
We thank you for listening. You can find a bunch of our other podcasts, including community broadband bits at ilsr.org/podcast. And as we continue the Building for Digital Equity podcast, we'd like to ask you a favor. Please give us a rating wherever you found it, especially at Apple Podcast. Share it with friends. You can even embed episodes on your own [00:17:30] site and let us know what you think. Write us@podcastscommunitynets.org. Finally, we'd like to thank joseph mcc.com for the song on the Verge.