The Journal of the American Medical Association examined the telehealth care usage of 148,402 patients who scheduled telemedicine visits from March 16th to May 11th during the early part of the COVID-19 crisis. The telehealth JAMA study by a University of Pennsylvania research team published in early January 2021 found that only 54.4% of patients actually completed a scheduled telemedicine visit. Of those completing their visit, just less than half of the patients used the video format, and the other half used the telephone for their visits. The study found that older patients and patients of Asian descent and non-English-speaking patients had lower telehealth care visit completion rates.
Telemedicine Visit Completion: Telephone versus Video
Interestingly, women were found to be more likely to complete telemedicine visits. Further, English-speaking patients, non-Asian patients, those with commercial health insurance, and younger patients were more likely to complete their visits as well. However, older people, Black and Latinx individuals, and those with lower incomes were less likely to use the video telemedicine format. Women were less likely to use video for their visits, especially for specialty care visits. Young white patients with a higher median household income were more likely to use the video format.
Improving Access to Telemedicine for All
While virtual care is likely here to stay, it must be made more accessible to communities of color and marginalized populations. Two keys to making that happen are expanding broadband access (See https://telehealth.org/telehealth-in-rural-areas/ and https://telehealth.org/telehealth-access/ for more information on efforts being undertaken) and coverage parity for telemedicine services (see https://telehealth.org/reimbursement-covid-19-telephone/ for more information about telephone reimbursement). Further, systems must be designed to address access inequities. This can be accomplished by engaging with community members from vulnerable populations to design technology accessible for all patients. (See https://www.psychiatrictimes.com/view/telepsychiatry-based-culturally-sensitive-collaborative-treatment for a proposed model of culturally sensitive telepsychiatry.)
Kathleen Judy, MS, LPCC-S is a licensed professional clinical counselor in Ohio. She has been serving clients in both a rural setting and a suburban community for 20 years. Her practice has evolved into providing services 100% via telehealth. She is a part-time Staff Writer for the Telebehavioral Health Institute.