Vivian Hsiao|Thevaa Chandereng|Robin Lankton|Jeffrey Huebner|Jeffrey J. Baltus|Grace E. Flood|Shannon Dean|Amyé Tevaarwerk|David Schneider
Disparities in Telemedicine Access: A Cross-Sectional Study of a Newly Established Infrastructure during the COVID-19 Pandemic
University of Wisconsin–Madison|Columbia University|University of Wisconsin–Madison|University of Wisconsin–Madison|UW Health University Hospital|Columbia University|University of Wisconsin–Madison|University of Wisconsin–Madison|University of Wisconsin Carbone Cancer Center|University of Wisconsin–Madison
covid19 pandemic led dramatic increases telemedicine use provide outpatient care without inperson contact risks telemedicine increases options health care access digital divide disparate access may prevent certain populations realizing benefits telemedicinethe study aimed understand telemedicine utilization patterns widespread deployment identify potential disparities exacerbated expanded telemedicine usagewe performed crosssectional retrospective analysis adults scheduled outpatient visits june 1 2020 august 31 2020 singleintegrated academic health system encompassing broad range subspecialties large geographic region upper midwest period time initial surge covid19 standard clinical services resumed beginning study period approximately 72 provider visits telemedicine visits primary study outcome whether patient one videobased visits compared audioonly telephone visits inperson visits secondary outcome whether patient telemedicine visits videobased audioonly compared inperson visits onlya total 197076 individuals eligible average age 46 years 56 females increasing age rural status asian blackafrican american race hispanic ethnicity selfpayuninsured status significantly negatively associated video visit digital literacy measured patient portal activation status significantly positively associated video visit medicaid medicare payer american indianalaskan native raceour findings reinforce previous evidence older age rural status lower socioeconomic status asian race blackafrican american race hispaniclatino ethnicity associated lower rates videobased telemedicine use health systems policies seek mitigate barriers telemedicine possible efforts digital literacy outreach equitable distribution telemedicine infrastructure