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Rebecca Fisher

2022–23 U.K. Harkness Fellow; General Practitioner and Senior Policy Fellow, The Health Foundation

Rebecca Fisher headshot

Placement: University of California, San Francisco

Mentors: Urmimala Sarkar, M.D., M.P.H., Professor, Division of General Internal Medicine; Associate Chair for Faculty Experience, Department of Medicine; Associate Director, UCSF Center for Vulnerable Populations, San Francisco General Hospital

Julia Adler-Milstein, Ph.D., Professor of Medicine and Director, Center for Clinical Informatics and Improvement Research, UCSF School of Medicine

Project: Equity and Telemedicine: How Can Primary Care Practices Increase Access to Telemedicine for Underserved Populations?

Rebecca (Becks) Fisher, M.A. (Cantab), MB BChir, MRCP (UK), MRCGP, FHEA, is a 2022–23 U.K. Harkness Fellow in Health Care Policy and Practice. She is a general practitioner in a deprived urban area, as well as a senior policy fellow at the Health Foundation, where she leads the organization’s work on general practice. Fisher is particularly interested in how health policy can support equitable provision of primary care services and in models of care and payment for general practice. She has served on multiple national advisory groups, including NHS England’s health inequalities in primary care advisory group, and the National Vaccine Equalities Committee for the COVID vaccine rollout. Fisher is a cofounder of Next Generation GP, a national leadership program for early-career GPs in the U.K. She was previously a National Medical Directors clinical fellow to Sir Bruce Keogh, and an academic clinical fellow at the University of Oxford, where she held a teaching fellowship at Green Templeton College. She completed her medical training at the University of Cambridge, where she graduated with the Roger Morris Prize for medicine and surgery.

Project Overview: Delivering high-quality health care equitably is a challenge for all countries. Telemedicine — the remote provision of clinical health care services — offers opportunities to mitigate workforce challenges experienced in primary care in the U.K. and U.S. Telemedicine use has accelerated in response to the COVID-19 pandemic, and remote consulting is embedded in both health systems.

People with the greatest health needs (for example, people experiencing socioeconomic deprivation) are often the least likely to receive high-quality health care. They are also the least likely to be digitally connected or digitally literate. Disparities in access to telemedicine could contribute to and amplify existing health inequalities.

This research seeks to understand how primary care practices can increase access to telemedicine for underserved populations. Encounters data will be used to quantitatively describe variation in use of telemedicine by underserved populations across practices in California. Primary care practices with the best and worst telemedicine access for underserved populations will be identified from the data and invited to participate in case studies. Subsequent detailed qualitative research will be used to understand factors driving either good or poor access to telemedicine for underserved people.