Direct-to-patient telemedicine: Expanding access to regional pediatric specialty care

Telemedicine is seen as a useful tool in reducing gaps in health care but this technology-enabled care can also exacerbate health inequity if not implemented with a focus on inclusivity. Though many studies have reported improvements as well as exacerbation of disparities in access to care in their...

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Bibliographic Details
Published in:	Journal of investigative medicine Vol. 72; no. 2; pp. 248 - 255
Main Authors:	Atabaki, Shireen M, Shur, Natasha E, Munoz, Ricardo A, Bhuvanendran, Shivaprasad, Sable, Craig, Rojas, Christina R, Lopez-Magallon, Alejandro J, Clarke, Jonas C, Sabouriane, Cyrus E, Krishnan, Anita, Wessel, David L
Format:	Journal Article
Language:	English
Published:	Los Angeles, CA SAGE Publications 01-02-2024
Subjects:	Child COVID-19 - epidemiology Delivery of Health Care Health Inequities Humans Telemedicine telemedicine access equity pediatrics
Online Access:	Get full text
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Summary:	Telemedicine is seen as a useful tool in reducing gaps in health care but this technology-enabled care can also exacerbate health inequity if not implemented with a focus on inclusivity. Though many studies have reported improvements as well as exacerbation of disparities in access to care in their telehealth programs, there does not exist a common evaluation tool to assess these programs. To mitigate the impact of COVID-19 on health care workers and protect medically vulnerable children, in March 2020 we expanded our pre-established specialty and subspecialty direct-to-patient pediatric telemedicine program in a high volume urban pediatric health system. Our program aimed to prevent disparities in pediatric health care. In this study, using a “Pillars of Access” approach as a model to evaluate impact and access to care of our direct-to-patient telemedicine program, we analyzed the patients that were seen pre-COVID versus post-COVID. Our study demonstrated an increase in telemedicine visits for patients from diverse socioeconomic and racial backgrounds, and geographically underserved communities. We also observed an increase in telemedicine visits for mental health complaints and for certain categories of high-risk patients. This study was not designed to identify language and cultural barriers to telemedicine. Future identification of these specific barriers is needed. The tool to evaluate telehealth impact/access to care through a “Pillars of Access” approach presented here could serve as a model for implementation of telehealth programs. Our study highlights telemedicine programs as a mechanism to address healthcare inequity and overcome barriers to care.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23
ISSN:	1081-5589 1708-8267 1708-8267
DOI:	10.1177/10815589231222197