White patients were majority users of video telehealth during the first months of the pandemic, but Black patients were 50% more likely to have virtual visits by mid-2020.
More patients are tapping into telemedicine during the COVID-19 pandemic, but while remote visits are growing among Black patients, they still face barriers that limit access, a new study shows.
The study, published online this week in Journal of the American College of Surgeons, found that in-person visits increased among Black and White patients as the pandemic dragged on in mid-2020. And while White patients continued to be majority users of video telehealth, Black patients were 50% more likely to have virtual visits than white patients.
The JACS study looked at 4,908 patients of general and gastrointestinal surgery at a Massachusetts academic medical center between March 24 and June 23, 2020, (Phase I) and from June 24 through December 31, 2020, (Phase II). The dates of the study were selected based on Massachusetts state policies that limited non-emergency surgical services, including outpatient consultations.
"During Phase I, 347 in-person and 638 virtual visits were completed. There were no significant differences in virtual compared to in-person visit use across demographic or insurance groups," the study reported. "Among patients utilizing virtual visits, Latinx and Hispanic patients were less likely to have video compared with audio-only visits than white patients."
Phase II saw 2,922 in-person and 1,001 virtual visits. No significant differences were observed across insurance types. "However, Black patients were more likely to have virtual visits than white patients. Among patients utilizing virtual visits, race or ethnicity and insurance type were not significant predictors of video use."
The study authors at Brigham and Women's Hospital in Boston believe that their findings provide evidence that virtual consultation can increase access to surgical care for underserved populations during the pandemic and beyond. The study called for hospitals to create policies to remote access for underserved populations.
"It's really interesting to sit here in January 2022 and analyze data on virtual care where about two years ago, we hardly ever used virtual care," said study coauthor Ali Tavakkoli, MD.
"The first wave of COVID pushed us to implement this path and format of care where we thought it would not be possible," Tavakkoli said. "Now the data, including this study, show that it can be done, and it can be done safely."
However, the study noted that technological barriers hamstring efforts to connect underserved populations to remote care. The study cited Federal Communications Commission findings that more than 21 million Americans still lack broadband access, and that internet capable device ownership remains disproportionately lower among low-income and older Americans.
"The surge in telemedicine has focused attention on the digital divide and highlighted the limited ability of vulnerable populations to access and use telemedicine," said study lead author Gezzer Ortega, MD, MPH, of Brigham and Women's Hospital in Boston.
“It's really interesting to sit here in January 2022 and analyze data on virtual care where about two years ago, we hardly ever used virtual care.”
Study coauthor Ali Tavakkoli, MD, Brigham and Women's Hospital
John Commins is a content specialist and online news editor for HealthLeaders, a Simplify Compliance brand.
KEY TAKEAWAYS
During Phase I, two-thirds of patients attended surgical consultation via telemedicine visits. The majority of these patients were white, and there were no statistically significant differences in virtual visit use across racial or ethnic groups.
During Phase II, in-person visits increased. White patients remained the majority of patients seen virtually, but Black patients were 50% more likely to have virtual visits than white patients.
Older age, lower education level, and non-English as a primary language were associated with decreased video use.