Technological Applications of Telehealth Platforms in Asylum Clinics
Author: Suzanne Zhou
Georgetown University School of Medicine
Importance The SARS-CoV-2 and its subsequent social precautions led to massive adaptations in the operation of free clinics and other low-cost health services. As technology advances, and with increasing pandemic probability, there is an increasing need to seek these services virtually. Physicians for Human Rights at Georgetown provides one of these disrupted essential healthcare services, evaluations for asylum seekers. In 2000-2004, the national PHR organization reported a 89% success rate for asylum cases with medical evaluations compared to a general asylum success rate of 37.5% (Lustig et al, 2008).
Objective PHR at GUSOM aimed to improve virtual access to healthcare professional and student trainings on conducting asylum evaluations as well as availability of psychological and physical evaluations at no cost to clients.
Evidence review We established the first virtual biannual Asylum Evaluations Training and educated previously trained evaluators with a webinar series on virtual evaluations by leading national experts. Findings PHR at GUSOM’s asylum clinic has completed 160 evaluations since its establishment in 2014; 25 evaluations were performed in 2020. We trained 80 clinicians and over 120 medical school students in the two 2020 virtual training sessions. To conduct the remote evaluations, evaluators used a variety of virtual platforms including Zoom, VSee, Bluestream Health, and Doxy.me. The virtual setting of the training sessions and evaluations increased access to educational events, healthcare providers, and decreased transportation limitations. While these increased the trained asylum evaluator pool, the virtual setting led to additional issues. The resource-poor population of asylum seekers that typically utilize the clinic’s evaluations are benefited by the decreased transportation to the evaluation sites; however, this same population experiences disadvantages such as decreased access to the internet, stable and private environment.
Conclusion and Relevance The application of the free, or low-price, technological tools to organize affordable care to uninsured and financially disadvantaged refugee seekers is promising but has some limitations. The virtual model of asylum evaluation training and evaluation conducting can apply to other free clinics to boost access to additional providers and improve coordination of care.
Lustig, S.L., Kureshi, S., Delucchi, K.L., Iacopino, V., Morse, S.C. Asylum Grant Rates Following Medical Evaluations of Maltreatment among Political Asylum Applicants in the United States. J Immigrant Minority Health (2008) 10:7–15. DOI 10.1007/s10903-007-9056-8