Imagining Access >> crip computing

By: Fan Yi, Armaan Sandhu, Mohammad Shohan

Remote Access Policies Table

Digital care is transforming the healthcare landscape, enabling innovative solutions to improve accessibility and reduce costs. At the University of Michigan, ongoing efforts like the e-Health & Artificial Intelligence Program (e-HAIL), Telehealth Research and Policy Initiative, Health AI Ethics and Policy Symposium, Academic Health Department Partnership pave the way for inclusive healthcare. This website explores current initiatives, future opportunities, and challenges in advancing digital care

Learn more about e-HAIL

We can expand digital health projects in conjunction with the e-HAIL program: Prioritize the development of accessible digital health tools for people with disabilities, such as telemedicine applications that integrate voice commands, screen reading support, and real-time sign language interpretation. For instance, telehealth platforms can be made more inclusive by integrating screen readers, voice commands, and even real-time sign language interpretation to enhance communication during consultations. AI-driven diagnostic tools could be customized to provide more personalized care, offering recommendations based on a person’s specific disability needs, such as mobility challenges or sensory impairments.

Explore the Telehealth Research and Policy Initiative

A key resource that is central to the new digital care world within the university is the Uwill Teletherapy resource. This resource allows students to have video, phone, chat, and message sessions with a licensed mental health professional for free. This is seen as a more flexible options if meeting in person is tough for people. The resource seems like a great tool to be used alongside in person therapy however not in replacement of it because some issues need that in person aspect. These ideas are listed in the website as they include things such as thoughts of self harm.

Through the Telehealth Research and Policy Initiative, we are adding multilingual support and cultural sensitivity features to ensure that people with disabilities who do not speak English as a native language have access to high-quality health care. We can access the digital care to decrease the cost of the patient in the future and making the healthcare more accessible.

One of the issues with teletherapy is that medical licensing laws prohibit healthcare providers from practicing outside the state of Michigan. This means that students who are leaving Michigan cannot continue to receive teletherapy services from their established care providers. In the future, some of these barriers might be addressed through the advancement of policy change at both federal and state levels. By adopting interstate compacts for telehealth licensing or creating national telehealth provider certifications, students could maintain continuity of care, regardless of location. Such reforms would enable more equitable access to mental health services for mobile student populations and align with the broader goals of accessible digital healthcare.

Discover AI in Medicine

• We found that our school is currently offering a course on artificial intelligence in medicine, which can help students and professionals understand the application of AI in medicine. In the future, We can build the educational and training program through the sharing videos and distance learning to improve the school’s digital literacy.

• Continuous Feedback Loops: Continuous feedback loops are essential for improving digital health technologies and workflows. In this website, university of Michigan researchers emphasize the importance of understanding patients’ concerns and needs when using AI in healthcare to ensure the effectiveness and acceptability of these technologies.

• With the development of AI: use AI for diagnostic tools, patient risk stratification, and personalized treatment recommendations. We can access the digital care to decrease the cost of the patient in the future and making the healthcare more accessible.

Digital care has recently taken over. But is this a good or bad thing? After Covid-19 in specific, the number of resources that were diverted towards digital care skyrocketed. This increased the amount of accessible care but also decreased the amount of face to face care which could be crucial.

The increase of digital care has been increased after the pandemic, however, many disabled people have been looking for such materials for an extremely long time. This brings up some very important people and groups that have been working to make care accessible far before the pandemic forced it. They can be easily found using the Remote Access Archive which is linked to here: https://www.criticaldesignlab.com/project/submit-to-remote-access-archive

The above video from the University of Michigan Youtube account, made by the university, highlights a commitment to overall health and wellbeing of people in the community. It touches on focusing on marginalized communities along with care equity but does not touch on digital care in specific.

While digital healthcare initiatives often cater to the traditional student demographic, accessibility is not uniform across the diverse student body. Nontraditional students, such as those balancing family responsibilities, full-time jobs, or part-time studies, often face unique challenges. For these individuals, telehealth tools must be adaptable to their schedules and environments. Providing flexible appointment times, offering asynchronous communication options, and integrating multilingual and culturally relevant resources are critical steps toward ensuring digital care meets the needs of every student, regardless of their life circumstances.

There are people who miss a walk outside, socialization, the interactions-everything that usually comes along with visiting a care venue. Some want this social interaction and others appreciate just staying in the comfort of their homes for their care. It becomes important to weigh hybrid models of care. Such models would allow patients to choose between in-person and virtual appointments based on their preferences and needs, fostering a more inclusive healthcare system that caters to diverse lifestyles.

In order to get some feedback about the digital care at the university we conducted an interview of 3 students. The questions and responses are listed below:

Interviews:

Student #1: Freshman,

1. What has your experience been with resources for mental health during your time at the University of Michigan?
   • My experience with mental health resources has been limited because I haven’t really reached out in order to experience it. But the one aspect that I have used is the accessibility of being able to talk to my counselor.
2. Is there anything lacking that you wish you had access too?
   • A big thing that I wish I had access to was some sort of group setting where I could talk to others.
3. Is accessibility a big issue for you whether online or in person during your time here?
   • Accessibility is not a big issue for me during my time here however I do feel that it is important.
4. Do you feel a greater appreciation of mental health from the university?
   • Yes I feel a good appreciation of mental health from the university through all the resources that are provided along with how those resources are promoted around campus, especially during this exam season. 
5. What forms of digital care have you seen/used?
   • I personally have not tried to use any but it is nice to know that they are here for me.

Student #2: Sophomore,

1. What has your experience been with resources for mental health during your time at the University of Michigan?
   • My experience with mental health resources has been few because I have only used one resource and that was the Individual Peer Counseling. That really helped me when I was stressed out and just wanted to talk.
2. Is there anything lacking that you wish you had access too?
   • I don’t know what is something I wish I had access to because there are a lot of resources provided to us.
3. Is accessibility a big issue for you whether online or in person during your time here?
   • Accessibility is not a big issue for me.
4. Has the increase of care digitally had a positive or negative effect on you?
   • The increase of digital care has had a positive impact on me because it just helps increase the accessibility of care and make reaching out even easier at the university.
5. Is the lack of human interaction as a result of digital care harmful to you?
   • The lack of human interaction is a downside for digital accessibility however I believe that its accessibility benefits overrules the harm.
6. Do you believe that the amount of digital care provided by the university is enough?
   • I do believe that the university provides enough digital care however some more staff on that would be good because the time needed before an appointment is quite long.

Student #3:

1. What are your thoughts on U of M’s resources for mental health?

I do feel a large amount of appreciation for mental health from the university through all the resources promoted.

1. What has your experience been with resources for mental health during your time at the University of Michigan?

My experience with mental health has been limited.

3. Is there anything lacking that you wish you had access too?

I feel quite fulfilled with the resources that I have access to because of the digital resources and the in person resources combined.

4. Is accessibility a big issue for you whether online or in person during your time here?

I do not personally have a big issue with accessibility.

5. How does accessibility and mental health intersect for you?

We believe that accessibility and mental health should go hand in hand as there should be accessible mental health resources, which is why I like the increase of digital mental health resources.

The emergence of Long COVID has highlighted a new wave of challenges for healthcare systems. Symptoms such as brain fog, extreme fatigue, and other persistent issues have led many individuals to identify as disabled for the first time. Digital care programs must adapt to support these patients by:

• Offering specialized telemedicine services tailored to the needs of individuals with Long COVID.
• Incorporating features such as simplified interfaces and tools for tracking cognitive and physical symptoms.
• Promoting research to understand the long-term impacts of Long COVID and develop evidence-based interventions.

Overall, we believe that the future development of digital care should focus on artificial intelligence, which can effectively help us improve efficiency and reduce the burden on patients. Moreover, it can solve the problem of high medical costs. Although there are some shortcomings, such as digital care cannot solve the problem of how the elderly can smoothly operate smart devices such as mobile phones and computers for online care. But we are still confident in the future of digital care. The University of Michigan is at the forefront of digital healthcare innovation. By prioritizing accessibility, ethical AI, and patient-centered design, we can create a future where healthcare is equitable and accessible for all.

Bibliography

Brazier, Megan. “Taylor Swift: The Eras Tour Review.” YouTube, uploaded by Megan Brazier, 2 Dec. 2024, https://www.youtube.com/watch?v=JIV6YDXVg2Q.

Institute for Healthcare Policy and Innovation. “Telehealth Research and Policy.” University of Michigan, https://ihpi.umich.edu/telehealth-research-and-policy. Accessed 9 Dec. 2024.

Institute for Healthcare Policy and Innovation. “E-Health & Artificial Intelligence Program (e-HAIL).” University of Michigan, https://ihpi.umich.edu/e-health-artificial-intelligence-program-e-hail. Accessed 9 Dec. 2024.

University of Michigan Medical School. “Crash Course: AI in Medicine.” University of Michigan Medical School, https://medschool.umich.edu/medicine-michigan/crash-course-ai. Accessed 9 Dec. 2024.