Telemedicine Failing Older Patients, Non-English Speakers, During Pandemic, Study Warns

The ongoing coronavirus pandemic has forced many medical providers to use telemedicine for certain types of treatments and appointments, but the findings of a new study suggest this left many patients without important treatments and care, especially among minorities, the elderly and those who do not speak English.

People of color and older individuals have been more likely not to keep telemedicine appointments during the coronavirus pandemic, according to a study published by researchers from the University of Pennsylvania, published December 29, in the journal JAMA Network Open.

Researchers analyzed whether inequities were present in telemedicine during the pandemic among various patient groups. The cohort study included medical record review from March 15, to May 11, 2020, and all patients scheduled for telemedicine visits in primary care and specialty clinics at a Penn Medicine academic health system.

The data include more than 148,000 patients who scheduled telemedicine visits during the study period at the height of the pandemic, especially in the northeast part of the country.

Of those appointments 54%, or roughly 80,000, were completed visits using telemedicine. Less than half were conducted via video and 56% were telephone visits.

The data indicated older patients, those of Asian race, non-English language speakers and patients who had Medicaid completed fewer telemedicine visits than other patients.

People ages 55 to 64 were 15% less likely than younger adults to complete telemedicine appointments. Similarly, those aged 65 to 74 years were 25% less likely to complete telemedicine visits and those over the age of 75 were 33% less likely have their scheduled telemedicine appointments.

Patients 55 to 74 were 20% less likely than younger adults to use technology for medical visits. Those over 75 years old were 51% less likely to use it to access medical care.

More so, older patients, female patients, Black and Latinx patients and those with household incomes less than $50,000 used video technology less for telemedicine visits than other patients.

Black and Latinx patients were 35% and 10% less likely than white patients to use telemedicine. Patients with household incomes less than $50,000 were 43% less likely to complete telemedicine visits.

Asian Americans were 31% less likely than white people to use telemedicine. Non-English speaking patients were also 16% less likely to use technology for medical visits.

The coronavirus pandemic has required a major shift in how healthcare may be delivered to patients in non-emergency situations. Healthcare systems are moving to include telemedicine platforms; however, many patients in the U.S. are being left behind simply because they lack access to technology or are uncomfortable using it.

The Federal Communications Commission estimates 21 million Americans don’t have access to the internet in their homes. Other sources suggest the estimates are closer to nearly 162 million Americans.

The use of telemedicine has risen consistently since the start of the pandemic. More than 1 billion patients accessed medical care last year using telemedicine. Researchers say it is a good way to help treat patients during the pandemic, but it does present challenges to patients in lower income communities, those who lack knowledge of technology, who don’t speak English, or don’t have access to the internet. Many patients are simply not receiving the care they need.

“Older patients, Asian patients, and non–English-speaking patients had lower rates of telemedicine use, while older patients, female patients, Black, Latinx, and poorer patients had less video use,” wrote study authors. “Inequities in accessing telemedicine care are present, which warrant further attention.”