Ensuring Equitable Implementation of Telemedicine in Perinatal Care

Ukoha, Erinma P.; Davis, Kelly D.; Yinger, Meredith; Butler, Blythe A; Ross, Tamia; Crear-Perry, Joia; Perron-Burdick, Misa; Nijagal, Malini A.

doi:10.1097/aog.0000000000004276

Cited by 47 publications

(51 citation statements)

References 16 publications

(11 reference statements)

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“…This suggests that barriers to telemedicine access disproportionately affected Black patients seeking care during the pandemic, leading to a greater reliance on in‐person visits than other groups. We hypothesize that technology‐associated disparities including access to video‐enabled devices and digital literacy may drive lower telemedicine use, 15 supported by our results that Black patients were significantly less likely to have an activated patient portal and email addresses on record relative to White patients. Finally, possible mistrust of the health care system and technology in Black communities may contribute to lower rates of telemedicine use 3 , 14 and may influence patients of color to prefer in‐person medical visits, especially if meeting with a new provider.…”

Section: Discussionsupporting

confidence: 53%

Disparities in telemedicine use during the COVID‐19 pandemic among pediatric dermatology patients

Duan

Luzuriaga

Schroedl

et al. 2022

Pediatric Dermatology

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Background/Objectives The COVID‐19 pandemic necessitated rapid implementation of telemedicine at medical centers across the United States. As telemedicine is expected to persist beyond the pandemic in subspecialties like pediatric dermatology, there is growing concern that socioeconomic factors may contribute to inequitable telemedicine access. This study aims to identify factors associated with disparities in telemedicine use among pediatric dermatology patients during the pandemic. Methods In this single‐center cross‐sectional study, patients less than 18 years old who completed a visit with a pediatric dermatologist via a video telemedicine call or in‐person office visit during the specified time periods were included. Univariate and multivariable analyses were performed to compare demographic factors for (1) patients who had a telemedicine visit versus office visit during June 1, 2020, to January 22, 2021, and (2) patients who had either visit type during June 1, 2020, to January 22, 2021, versus June 1, 2019, to January 2020. Results The independent factors associated with lower odds of telemedicine include identifying as Black/African American, having a non‐English preferred language, and having public insurance, whereas the independent factors reducing overall access to pediatric dermatology care during the pandemic include identifying as Hispanic/Latino and having public insurance. Conclusions Differential telemedicine use in vulnerable communities may be attributed to disparities in technology access and digital literacy and should be addressed at a structural level. If such disparities are identified and adequately remedied, telemedicine can serve as an important tool for expanding access in the field of pediatric dermatology.

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Section: Discussionsupporting

confidence: 53%

Disparities in telemedicine use during the COVID‐19 pandemic among pediatric dermatology patients

Duan

Luzuriaga

Schroedl

et al. 2022

Pediatric Dermatology

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“…As regards telehealth (vs in-person check-ups), our data aligns with previous studies showing that it has been rapidly adopted in perinatal care since the onset of the pandemic (36)(37)(38)(39). Telehealth offers safe access to consultation and follow-up appointments, saving patients both time and money, but is a complex system that normally requires years of implementation and optimization (40) in order to be an effective tool for providing comprehensive and multidisciplinary perinatal care, mainly in cases where physical examination is not or is rarely necessary.…”

Section: Discussionsupporting

confidence: 90%

Estimating the Impact of the COVID-19 Pandemic on Maternal and Perinatal Health Care Services in Italy: Results of a Self-Administered Survey

Cena

Rota

Calza

et al. 2021

Front. Public Health

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The coronavirus disease 2019 (COVID-19) pandemic is strongly changing the way most people live their lives, and disrupting specialist healthcare systems. Such public health disruptions have resulted in significant collateral damage with particular implications for vulnerable populations, including the perinatal population. This Study aims to estimate the impact of the COVID-19 pandemic on Italian maternal and perinatal health care services. A questionnaire was designed to evaluate the COVID-19 impact on Italian maternal and perinatal healthcare facilities and their activities and provision of services from March to May 2020. The survey was completed by hospital-based and community-based Italian maternal and perinatal healthcare facilities. Most of these were located in Lombardy or Veneto (the most affected Italian regions). 70% of all facilities reported that the first wave of the COVID-19 pandemic negatively influenced the functioning of one or more aspects of the perinatal service; only 28.4% of facilities all over the country continued to provide outpatient routine visits and examinations as usual; 23.4% of facilities became understaffed during the index period due to various reasons such as ward transfer and sick leave. This is the first Italian study, and among very few international studies that describe the effects of the COVID-19 pandemic on antenatal and postnatal healthcare facilities and their provision of activities and services. Our findings confirm that healthcare systems even in high-income countries were not entirely prepared to handle such a global health emergency; indeed, specialized maternal and perinatal healthcare services have been disrupted by this global health emergency.

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“…For example, many women in this study mentioned positive aspects of avoiding the full glucose tolerance test. This, in conjunction with the previously mentioned study suggesting the safety of telehealth, provides a basis for cautious research to begin into how telehealth can best be incorporated more fully into the maternity care system, ideally in a manner that avoids the exacerbation of health disparities, especially for low income women ( Fernandez Turienzo et al, 2021 ; Palmer et al, 2021 ; Ukoha et al, 2021 ; Westwood, 2021 ). Another key consideration will be ensuring that telehealth services are of high quality and can adequately maintain the relationship between patient or client and provider, which previous research (as well as data from our study) has suggested to be integral to a positive pregnancy and birth experience ( Hildingsson et al, 2019 ; Lewis, 2019 ).…”

Section: Discussionmentioning

confidence: 73%

“Never let a good crisis go to waste”: Positives from disrupted maternity care in Australia during COVID-19

2022

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Ensuring Equitable Implementation of Telemedicine in Perinatal Care

Abstract: Telemedicine in perinatal care has the potential to reduce disparities in maternal and perinatal health outcomes if implemented in an equitable manner.

Cited by 47 publications

References 16 publications

Disparities in telemedicine use during the COVID‐19 pandemic among pediatric dermatology patients

Disparities in telemedicine use during the COVID‐19 pandemic among pediatric dermatology patients

Estimating the Impact of the COVID-19 Pandemic on Maternal and Perinatal Health Care Services in Italy: Results of a Self-Administered Survey

“Never let a good crisis go to waste”: Positives from disrupted maternity care in Australia during COVID-19

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