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New Study Finds Telehealth Reduced Barriers to Access for Black Patients

Analysis  |  By Eric Wicklund  
   May 12, 2022

Penn Medicine researchers have found that the health system's virtual care platform not only allowed Black patients to access care as easily as non-Black patients during the pandemic, but is keeping them coming back for more health services.

Penn Medicine researchers are reporting that a telehealth platform is helping the health system reduce barriers to access for Black patients.

In a study published in Telemedicine and e-Health, researchers from the Perelman School of Medicine at the University of Pennsylvania found that a virtual care program set up during the pandemic allowed Black patients to access care at the same rate as other populations. And that platform is continuing to erase “historic inequities” affecting those patients as the pandemic eases and the health system offers both in-person and virtual care.

“We looked through the entire year of 2020, not just the first half of the year when telemedicine was the only option for many people, and the appointment completion gap between Black and non-Black patients closed,” Krisda Chaiyachati, MD, an assistant professor of medicine at Penn Medicine and the study’s senior author, said in a press release. “Offering telemedicine, even though it was for a crisis, appears to have been a significant step forward toward addressing long-standing inequities in healthcare access.”

The study addresses the validation of telehealth in tackling barriers to healthcare access for underserved populations. Telehealth advocates say virtual care could be an important tool in connecting with people who have problems visiting the doctor’s office or hospital due to geographical, cultural or social issues. Some also worry that telehealth could compound that problem because some populations might not be able to afford, access or use the technology.

Chaiyachati, who oversees the Penn Medicine OnDemand virtual visit program, and his colleagues studied how Black patients in the Philadelphia area accessed their primary care providers in 2019 and 2020, and compared that to PCP access by non-Black patients. Looking at roughly 1 million appointments per year, they found that completed PCP visits by Black patients increased from about 60% in 2019 to more than 80% in 2020, while the completed PCP rate for non-Blacks rose from 70% to more than 80%.

In fact, the study showed that Blacks used telehealth more than non-Blacks, with one-third of the former’s visits conducted by telehealth in 2020 and a quarter of the latter’s visits via virtual care.

“The specific time periods where we saw significant gains made by Black patients came when telemedicine was well-established in our health system,” Chaiyachati said. “This does not appear to be a coincidence.”

Looking more closely at the numbers, Chaiyachati and his colleagues found that Black patients steered clear of healthcare during the height of the pandemic in 2020, when the nation was practically shut down, but those visits rose back up to and even above 2019 levels when the pandemic subsided.

“Telemedicine allowed patients to seek non-urgent primary care despite hesitancy for in-person visits pre-vaccine,” Corinne Rhodes, MD, an assistant professor of internal medicine and assistant medical director of quality in Penn Medicine’s primary care service line and the study’s co-author, said in the press release. “Providing chronic disease management and preventive care helped return primary care offices closer to pre-pandemic business as usual.”

The next step will be to ensure underserved patients continue to use telehealth when it’s available and convenient, allowing providers to address health concerns that extend beyond COVID-19 and which affect long-term clinical outcomes.

Eric Wicklund is the Innovation and Technology Editor for HealthLeaders.


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