Previously submitted to: JMIR Medical Informatics (no longer under consideration since Oct 09, 2020)
Date Submitted: Sep 2, 2020
Open Peer Review Period: Sep 2, 2020 - Oct 28, 2020
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Differences in Health Access and Disparities between Phone and Video-based Virtual Care: A Cross Sectional Study
ABSTRACT
Background:
Health systems have rapidly adopted telehealth as an alternative healthcare delivery mode in response to the Covid-19 pandemic.
Objective:
The objective of this study was to compare the effectiveness of telemedicine modalities namely, phone and video, on health access, disparities, and service outcomes.
Methods:
We conducted a cross-sectional study of outpatients with telemedicine visits using a state-wide, on-demand telehealth service. Virtual Urgent Care (VUC) clinic data was collected from March 3rd, 2020 through May 3rd, 2020 using the institutional data warehouse.
Results:
Of 1803 telemedicine visits, 1278 (70.9%) were of patients who were female, 730 (40.5%) were of ages 18-34, 1423 (78.9%) were uninsured. Significant relationships between telemedicine modalities and gender (p-value=0.0002), age (p-value<0.0001), insurance status (p-value<0.0001) health access (p-value = 0.0094), and prescriptions given (p-value < 0.0001). Phone visits provided significantly more access to rural areas than video visits (p<0.01). Of all rural visits, 170 (68%) were from phone visits and 80(32%) were video visits. Significant differences were found in medication prescription rates between phone and video visits (p<0.01), visit wait times (p<0.0001), and visit duration (p<0.0001).
Conclusions:
We found that the combination of phone and video visits meet the needs of various vulnerable populations, and has substantial effect on improving access, reducing disparities while maintaining high quality telemedicine services. To improve the adoption rates and quality of telemedicine visits, more work is needed in building internet capacity within our rural communities, increasing awareness among patients to choose the correct telemedicine modality, and creating policies to ensure fairness in service outcomes between phone and video visits.
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