Disparities in Video and Telephone Visits Among Older Adults During the COVID-19 Pandemic: Cross-Sectional Analysis

Schifeling, Christopher H.; Shanbhag, Prajakta; Johnson, Angene; Atwater, Riannon C; Koljack, Claire E; Parnes, Bennett; Vejar, Maria M; Farro, Samantha; Phimphasone-Brady, Phoutdavone; Lum, Hillary D.

doi:10.2196/23176

Cited by 115 publications

(106 citation statements)

References 19 publications

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“…This is despite the fact that video visits were longer, and more diagnoses were discussed between the physician and the patient during video visits. 16 Racial and income disparities with respect to use of telemedicine have been shown using employer-sponsored insurance claims data with patients living in zip codes with lower income or majority racial/ ethnic populations experiencing lower adoption of telemedicine. 17 These disparities stress the importance of outreach to specific communities.…”

Section: Discussionmentioning

confidence: 99%

Telemedicine Utilization at an Academic Medical Center During COVID-19 Pandemic: Are Some Patients Being Left Behind?

Lott

Campbell

Hutzler

et al. 2022

Telemedicine and e-Health

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Introduction:The purpose of this study was to examine the use of telemedicine at one academic health care center during the COVID-19 pandemic to identify opportunities to improve access to this novel delivery method of care. Methods: All patients who underwent telemedicine visits at one urban academic medical center between March 2020 and June 2020 were included. All departments were included including surgical and nonsurgical. Demographic data, primary language, and visit type were collected. Primary zip code was used as surrogate for socioeconomic status through use of the zip code median household income. The demographics of the New York metropolitan area were obtained through the U.S. Census Bureau and used as a control cohort. Results: A total of 362,413 telemedicine visits met inclusion criteria with the majority of visits performed in April and May; 127,851 (35.3%) and 110,166 (30.4%), respectively. The highest performing department was Internal Medicine, which performed 72,796 visits or 20% of the total cohort. In our cohort of telemedicine patients, 59.6% identified as White, 11.4% as Black, and 5.7% as Asian. This is less diverse than the overall population of the metropolitan area, which is 17.5% Black and 11.5% Asian. There was also a large gender gap in the utilization of telemedicine services in general, where women (60.2%) were more likely than men (39.8%) to utilize the virtual visits. In addition, although over a third of patients in the Metropolitan area have median household incomes of <50,000, this population only represented 13.6% of our total cohort. Conclusions: This study highlights both the capability of telemedicine to provide care at a large urban academic medical center during a pandemic in addition to identifying potential gaps in care with telemedicine. The disparities highlighted in our cohort stress the importance of outreach to non-White older patients of lower socioeconomic status.

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Section: Discussionmentioning

confidence: 99%

Telemedicine Utilization at an Academic Medical Center During COVID-19 Pandemic: Are Some Patients Being Left Behind?

Lott

Campbell

Hutzler

et al. 2022

Telemedicine and e-Health

View full text Add to dashboard Cite

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“…In terms of adapting to technological advances, adults may benefit from becoming proficient with using a smartphone (e.g., Charness & Boot, 2009), accessing digital medical records (e.g., Levy et al, 2015), identifying fake news from real news on social media (e.g., Grinberg et al, 2019), and avoiding online scams (e.g., Burnes et al, 2017). Recently, due to COVID-19 physical distancing restrictions, an increasing number of doctor's appointments are held online via telehealth apps (e.g., Schifeling et al, 2020;Wosik et al, 2020), in addition to medical care providers using and sharing digitized medical records with patients (e.g., Malhotra & Lassiter, 2014). In some areas, ride-hailing apps (e.g., Uber/Lyft) may provide expanded travel access to older adults with restricted mobility (e.g., Vivoda et al, 2018).…”

Section: Learning New Skills and Content Is An Important Privilege Inmentioning

confidence: 99%

Learning as an Important Privilege: A Life Span Perspective with Implications for Successful Aging

Zhao

Cheung

et al. 2021

Human Development

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Research has demonstrated the cognitive and mental health benefits of learning new skills and content across the life span, enhancing knowledge as well as cognitive performance. We argue that the importance of this learning – which is not available equally to all – goes beyond the cognitive and mental health benefits. Learning is important for not only the maintenance, but also enhancement of functional independence in a dynamic environment, such as changes induced by the COVID-19 pandemic and technological advances. Learning difficult skills and content is a privilege because the opportunities for learning are neither guaranteed nor universal, and it requires personal and social engagement, time, motivation, and societal support. This paper highlights the importance of considering learning new skills and content as an important privilege across the life span and argues that this privilege becomes increasingly exclusionary as individuals age, when social and infrastructural support for learning decreases. We highlight research on the potential positive and negative impacts of retirement, when accessibility to learning opportunities may vary, and research on learning barriers due to low expectations and limited resources from poverty. We conclude that addressing barriers to lifelong learning would advance theories on life span cognitive development and raise the bar for successful aging. In doing so, our society might imagine and achieve previously unrealized gains in life span cognitive development, through late adulthood.

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“…Due to people's interest in the transition from traditional care to digital care, which has considerably increased as a result of the COVID-19 pandemic, evidence related to HCPs', patients', and caregivers' experiences with this transition has been emerging in various fields of medicine [15][16][17][18][19][20][21][22][23][24][25][26][27][28]. A variety of health care providers have shown increasing interest in the possibilities of digital health.…”

Section: Introductionmentioning

confidence: 99%

Shaping Workflows in Digital and Remote Diabetes Care During the COVID-19 Pandemic via Service Design: Prospective, Longitudinal, Open-label Feasibility Trial

Braune¹,

Boß²,

Schmidt-Herzel³

et al. 2021

JMIR Mhealth Uhealth

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Background The COVID-19 pandemic poses new challenges to health care providers and the delivery of continuous care. Although many diabetes technologies, such as insulin pumps and continuous glucose monitors, have been established, the data from these devices are rarely assessed. Furthermore, telemedicine has not been sufficiently integrated into clinical workflows. Objective We sought to remotely support children with type 1 diabetes and their caregivers, enhance the clinical outcomes and quality of life of children with diabetes, increase multiple stakeholders’ engagement with digital care via a participatory approach, evaluate the feasibility of using an interoperable open-source platform in a university hospital setting, and analyze the success factors and barriers of transitioning from conventional care to digital care. Methods Service design methods were used to adapt clinical workflows. Remote consultations were performed on a monthly and on-demand basis. Diabetes device data were uploaded from patients’ homes to an open-source platform. Clinical and patient-reported outcomes were assessed before, during, and after the COVID-19 lockdown period in Germany. Results A total of 28 children with type 1 diabetes and their caregivers enrolled in this study and completed 6 months of remote visits. Of these 28 participants, 16 (57%) also opted to attend at least one of their regular visits remotely. After 3 months of remote visits, participants’ time in range (P=.001) and time in hyperglycemia (P=.004) significantly improved, and their time in hypoglycemia did not increase. These improvements were maintained during the COVID-19 lockdown period (ie, between months 3 and 6 of this study). Participants’ psychosocial health improved after 6 months. Conclusions Remote consultations and commonly shared data access can improve the clinical outcomes and quality of life of children with type 1 diabetes, even during challenging circumstances. A service design approach helped with the delivery of comprehensive and holistic solutions that accounted for the needs of multiple stakeholders. Our findings can inform the future integration of digital tools into clinical care during and beyond the pandemic. Trial Registration German Clinical Trials Register DRKS00016170; https://tinyurl.com/skz4wdk5

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Disparities in Video and Telephone Visits Among Older Adults During the COVID-19 Pandemic: Cross-Sectional Analysis

Cited by 115 publications

References 19 publications

Telemedicine Utilization at an Academic Medical Center During COVID-19 Pandemic: Are Some Patients Being Left Behind?

Telemedicine Utilization at an Academic Medical Center During COVID-19 Pandemic: Are Some Patients Being Left Behind?

Learning as an Important Privilege: A Life Span Perspective with Implications for Successful Aging

Shaping Workflows in Digital and Remote Diabetes Care During the COVID-19 Pandemic via Service Design: Prospective, Longitudinal, Open-label Feasibility Trial

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