Telemedicine has the potential to improve access for populations historically excluded from high-quality healthcare, but attention must be paid to the context in which it is implemented such that it does not worsen health disparities by exacerbating inequities in access or by introducing inequities in quality.

Innovations such as telemedicine greatly improved healthcare delivery during the COVID-19 pandemic and beyond. It enabled individuals in quarantine, those living in remote areas, or those unable to physically visit their doctors to connect with healthcare providers, exchange health information, and receive treatment remotely. However, in other contexts, health inequities deepened for populations lacking the financial resources to access electronic devices or the digital literacy needed to navigate new technologies.

The diagram in the article illustrates healthcare as a complex adaptive system and highlights how individuals interact with the process of accessing healthcare throughout their lifespan. It depicts the care-seeking process and the nuances of healthcare delivery, which are influenced by a variety of factors; including human, structural, environmental, and sociopolitical elements.

leaders must commit to interventions that seek to repair, remediate, restructure, and remove structures that confer disadvantage in care delivery alongside the implementation of innovation

A concrete action that a nurse leader can take to address disparities should be inspired by the R4P framework—Remove, Repair, Remediate, Restructure, and Provide. For example, the nurse leader can use feedback loops to assess the nature of disparities specific to a particular community and respond in a way that aligns with the community’s unique needs and context. They may collaborate with assistance programs to provide electronic devices, offer access to free or reduced-cost internet, and organize teaching sessions to help individuals learn how to use these technologies effectively.