Infectious Disease

Racial, Socio-Financial Gaps in Telemedicine

January 09, 2021

2 min read

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Disclosure:
Adusumalli does not report any relevant financial information. In the study you will find all relevant financial information from all other authors.

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According to a study published on JAMA Network Open, elderly, Asian, and non-English speaking patients were less likely to use telemedicine in the early days of the pandemic.

The researchers also found that black, Latin American, and poorer patients were less likely to use video when making telemedicine visits than when making phone calls. The results suggest that there are gaps in telemedicine coverage that may require attention, the researchers said.

Srinath Adusumalli quote

“We have seen telemedicine have advantages, but we currently have a pretty unique opportunity to build our telemedicine delivery system as we scale it.” Srinath Adusumalli, MD, MSc, FACC, said Healio, assistant professor of clinical medicine and assistant chief medical information officer of connected health strategies and applications at the University of Pennsylvania Medical School.

“Part of that is that we need to make sure we reach all of the patients we care for fairly,” said Adusumalli. “Relying on the use of technology to maintain access to care is particularly evident because of concerns about the digital divide.”

Adusumalli and colleagues conducted a retrospective cohort study of patients designated for specialty outpatient clinics and telemedicine visits to primary care in the University of Pennsylvania health care system. They reviewed the medical records for the patients between March 16, 2020 and May 11, 2020 and identified the patients’ age, race, language, gender, median income, and type of insurance. The researchers then examined the connections between sociodemographic factors, the use of telemedicine and the use of video telemedicine.

They identified 80,780 patients who completed telemedicine visits during the study period. Overall, 45.6% of the visits were made by video and 56.9% by phone. 55 to 64 years old (adjusted OR = 0.85; 95% CI, 0.83-0.88), 65 to 74 years (aOR = 0.75; 95% CI, 0.72-0.78) and 75 years or older (aOR = 0.67; 95%) CI, 0.64-0.7) was associated with fewer completed telemedicine visits. Asian (aOR = 0.69; 95% CI, 0.66-0.73), non-English speaking (aOR = 0.84; 95% CI, 0.78-0.9) and Medicaid (aOR = 0.93 ; 95% CI, 0.89-) 0.97) were also associated with fewer telemedicine visits.

Adusumalli said that while telemedicine has been around for years, the way the technology is scaled is “relatively new” and gives researchers an opportunity to improve on how it is built.

“It’s not necessarily that the use of telemedicine limits access to care – it can potentially improve access to care – it’s just that the systems we design need to be designed with that in mind,” he said.

Adusumalli also said that one of the benefits of telemedicine is that providers can see the context of a patient’s life and gain insight into details like how their medication is organized.

“The increased use of telemedicine has been helpful in maintaining access to care during the COVID-19 pandemic while maintaining safety from a physical distance perspective,” he said. “Alongside this, we’ve also seen some benefits of telemedicine that include convenience – especially for patients who have access to visits without going directly into the physical environment of a hospital.”

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Race and medicine

Race and medicine

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