Telehealth used less in disadvantaged areas, Health Affairs study finds

A Health Affairs review identified that telemedicine use for the duration of the COVID-19 pandemic was reduced in communities with larger prices of poverty – suggesting that the industry have to deal with the electronic divide in purchase to be certain prevalent obtain to digital care.

The review, which was done by researchers from Harvard and the RAND Company, examined the variation in total outpatient visits and telemedicine use among sixteen.seven million commercially insured and Medicare Edge enrollees from January via June 2020.  

“While the maximize in telemedicine use for the duration of the pandemic is broadly recognized, it is unclear how the use of telemedicine and in-individual care has varied throughout individual demographics, scientific specialties, and medical conditions,” wrote the investigate crew.  

All through the COVID-19 time period of the review, researchers identified that 30.1{ae9868201ea352e02dded42c9f03788806ac4deebecf3e725332939dc9b357ad} of total visits have been furnished via telemedicine – with a whopping 20-a few-fold maximize in weekly amount of telemedicine visits, compared to the pre-COVID-19 time period.   

Continue to, all round check out quantity lowered by 35{ae9868201ea352e02dded42c9f03788806ac4deebecf3e725332939dc9b357ad}, boosting considerations about the effects of deferred care in the upcoming.  

WHY IT Matters

Telehealth has been hailed as a panacea for unequal obtain to care, but the info has frequently suggested or else.

Scientists identified that the percentage of total visits furnished via telemedicine was smallest among all those more mature than 65. Rural counties also saw reduced percentages of telemedicine use when compared to city counties.

When it comes to scientific specialties, the review identified that right before March seventeen, 2020, much less than two{ae9868201ea352e02dded42c9f03788806ac4deebecf3e725332939dc9b357ad} of clinicians in each individual specialty sent any outpatient care via telemedicine, with the exception of mental health clinicians.

All through the COVID-19 time period, psychiatrists, gastroenterologists, endocrinologists and social staff furnished extra than 50 percent of their visits nearly, with psychologists and neurologists not considerably at the rear of.  

By contrast, specialties these kinds of as ophthalmology missing most of their scientific quantity early in the pandemic.  

“While there was variability in the magnitude of changes throughout distinctive individual populations and scientific disciplines, each and every section of the health care technique skilled a fall in the all round quantity of care, such as crucial prevalent chronic conditions these kinds of as diabetic issues and hypertension,” wrote the researchers.

Scientists also famous reduced telemedicine use in higher-poverty locations, though also flagging that the review population disproportionately integrated used older people and their household members with professional coverage. In a independent Health Affairs site, health plan professionals famous that Medicaid consumers have had “much less steady” obtain to telemedicine.  

THE Greater Trend  

As questions linger about the upcoming of telehealth amid a continuing pandemic, researchers and advocates are inspecting which people today have benefited from expanded obtain – and who has been left at the rear of.

A wide-ranging review posted in December identified that more mature people today, ladies, Black and Latinx people today and patients with reduced family incomes have been much less very likely to use online video for telemedicine care, and that more mature patients, Asian people today and non-English-speaking people today had reduced prices of concluded telehealth visits.

“We have to be intentional with implementation to be certain that all patients are geared up to successfully take part in telemedicine care,” wrote the researchers in that review.  

ON THE Document  

“Our analyses, replicated at the health technique stage, could tell plan to make up for months of deferred care,” mentioned Health Affairs researchers.

“Health systems could allocate assets to individual outreach initiatives these kinds of as phone phone calls or reminder messages, prioritizing patients whose conditions saw the greatest fall in check out quantity. Additionally, additional scientific ability could be allocated to specialties with the greatest backlogs of deferred care,” they wrote.

“At last, health systems could prioritize chronic sickness populations, who have been extra very likely to have deferred care, for focused population administration.”

Kat Jercich is senior editor of Healthcare IT News.
Twitter: @kjercich
Electronic mail: [email protected]
Healthcare IT News is a HIMSS Media publication.