Telemedicine and Health Disparities During COVID-19

Katzow, Michelle; Steinway, Caren; Jan, Sophie

doi:10.1542/peds.2020-1586

Cited by 166 publications

(141 citation statements)

References 3 publications

(2 reference statements)

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“…Findings regarding attendance were largely consistent with hypotheses and indicated an increase in the number of appointments attended following the transition to telehealth. This may be because telehealth allows for more flexibility in scheduling and a reduction in logistical barriers (e.g., transportation) that often affect lower income families in particular ( Katzow et al., 2020 ). There were also fewer canceled appointments following the transition to telehealth, likely due to reduced barriers.…”

Section: Discussionmentioning

confidence: 99%

“…For instance, inconvenient appointment times, transportation, and the need for childcare create obstacles for families with limited resources. Telehealth offers a potential avenue for addressing these concerns, especially when families are able to access telehealth services via familiar mobile applications ( Katzow et al., 2020 ). Telehealth is an especially promising modality given that the vast majority of individuals, including those with lower incomes, have access to the internet via smartphones ( Van Veen et al., 2019 ).…”

Section: Introductionmentioning

confidence: 99%

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Mental health services in primary care: Evidence for the feasibility of telehealth during the COVID-19 pandemic

Frank

Grumbach

Conrad

et al. 2021

Journal of Affective Disorders Reports

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Background This study examined the transition to telehealth services during the COVID-19 pandemic in terms of attendance rates, the provision of evidence-based interventions, and clinical outcomes. Methods The feasibility of in-person versus telehealth visits for integrated primary care sessions was compared using chart review data. Data on patient characteristics, attendance, symptom severity and improvement, and evidence-based intervention use were collected for patients ( N = 173) from an integrated primary clinic that primarily serves a low-income, diverse sample of adults and children whose primary presenting problems are depression and anxiety. Results Attendance significantly improved after the transition to telehealth, as indicated by fewer cancellations and more appointments attended. Patients showed significant improvement and decreases in symptoms. The quality of care was maintained, as indicated by consistent evidence-based intervention use over time. Limitations This study was limited by the fact that it took place in an academically-affiliated primary care clinic, which may not be representative of all community settings. In addition, analyses related to clinical symptoms were only conducted with a small subset of participants and there was no comparison group. Conclusions Telehealth through integrated primary care might be a viable option to improve accessibility of mental health services for low-income, racial/ethnic minority adults and children.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Mental health services in primary care: Evidence for the feasibility of telehealth during the COVID-19 pandemic

Frank

Grumbach

Conrad

et al. 2021

Journal of Affective Disorders Reports

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“…Similarly, smaller percentages of participants who reported lower household incomes and educational attainment participated in telehealth when compared to peers of higher income and educational status, realities that have also been noted in previous literature on digital health use [18,20,25]. Other researchers have noted measures HCPs can take to try to ensure telehealth does not exacerbate health inequities during the pandemic (eg, ensuring language interpreter access, recruiting telehealth staff from diverse backgrounds, providing patient trainings in telehealth use, and informing patients about free or discounted broadband access) [25,26]. Thus, future outreach efforts should focus on equitable communication and engagement of patients in telehealth practices.…”

Section: As Telehealth Outreach Increases Hcps Can Optimize Virtualmentioning

confidence: 66%

Telemedicine Use and Health-Related Concerns of Patients With Chronic Conditions During COVID-19: Survey of Members of Online Health Communities (Preprint)

Horrell¹,

Hayes²,

Herbert³

et al. 2020

Preprint

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BACKGROUND It has been widely communicated that individuals with underlying health conditions are at higher risk of severe disease due to COVID-19 than healthy peers. As social distancing measures continue during the COVID-19 pandemic, experts encourage individuals with underlying conditions to engage in telehealth appointments to maintain continuity of care while minimizing risk exposure. To date, however, little information has been provided regarding telehealth uptake among this high-risk population. OBJECTIVE The aim of this study is to describe the telehealth use, resource needs, and information sources of individuals with chronic conditions during the COVID-19 pandemic. Secondary objectives include exploring differences in telehealth use by sociodemographic characteristics. METHODS Data for this study were collected through an electronic survey distributed between May 12-14, 2020, to members of 26 online health communities for individuals with chronic disease. Descriptive statistics were run to explore telehealth use, support needs, and information sources, and z tests were run to assess differences in sociodemographic factors and information and support needs among those who did and did not use telehealth services. RESULTS Among the 2210 respondents, 1073 (49%) reported engaging in telehealth in the past 4 months. Higher proportions of women engaged in telehealth than men (890/1781, 50% vs 181/424, 43%; P=.007), and a higher proportion of those earning household incomes of more than US $100,000 engaged in telehealth than those earning less than US $30,000 (195/370, 53% vs 241/530 45%; P=.003). Although 59% (133/244) of those younger than 40 years and 54% (263/486) of those aged 40-55 years used telehealth, aging populations were less likely to do so, with only 45% (677/1500) of individuals 56 years or older reporting telehealth use (P<.001 and P=.001, respectively). Patients with cystic fibrosis, lupus, and ankylosing spondylitis recorded the highest proportions of individuals using telehealth when compared to those with other diagnoses. Of the 2210 participants, 1333 (60%) participants either looked up information about the virus online or planned to in the future, and when asked what information or support would be most helpful right now, over half (1151/2210, 52%) responded “understanding how COVID-19 affects people with my health condition.” CONCLUSIONS Nearly half of the study sample reported participating in telehealth in the past 4 months. Future efforts to engage individuals with underlying medical conditions in telehealth should focus on outreach to men, members of lower-income households, and aging populations. These results may help inform and refine future health communications to further engage this at-risk population in telehealth as the pandemic continues.

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“…In conclusion, despite the broadening scope of telemedicine and rapid roll-out during the COVID-19, systemic issues such as organizational readiness, including digital maturity, licensing, regulatory hurdles, reimbursements, ability to be used by all groups, including the oldest and those with disabilities, infrastructural issues and geographical and digital disparities in telemedicine adoption warrant urgent attention [Bhaskar et Telemedicine could play an important role in expanding the outreach to remote areas and those from vulnerable backgrounds (8,9), as well as to developed and under-developed nations carrying a disproportionate burden of vulnerable communities [Bhaskar et al (a)]. This should be complemented with efforts to standardize telemedicine care and/or workflows using common tools for the clinical examination which could improve telemedicine practice and quality of care (10).…”

Section: Editorial On the Research Topic Telemedicine During And Beyomentioning

confidence: 99%

Editorial: Telemedicine During and Beyond COVID-19

Bhaskar

Nurtazina

Mittoo

et al. 2021

Front. Public Health

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Telemedicine and Health Disparities During COVID-19

Cited by 166 publications

References 3 publications

Mental health services in primary care: Evidence for the feasibility of telehealth during the COVID-19 pandemic

Mental health services in primary care: Evidence for the feasibility of telehealth during the COVID-19 pandemic

Telemedicine Use and Health-Related Concerns of Patients With Chronic Conditions During COVID-19: Survey of Members of Online Health Communities (Preprint)

Editorial: Telemedicine During and Beyond COVID-19

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