Telehealth Use Among Safety-Net Organizations in California During the COVID-19 Pandemic

Uscher‐Pines, Lori; Sousa, Jessica L.; Jones, Maggie; Whaley, Christopher; Perrone, Christopher; McCullough, Colleen; Ober, Allison J.

doi:10.1001/jama.2021.0282

Cited by 116 publications

(104 citation statements)

References 1 publication

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“…The COVID-19 pandemic led to a decline of in-person clinical visits. 1 Telemedicine increased during this time, but there was lower uptake in high-poverty areas. 2 For patients newly diagnosed with cancer, a delay in care could cause irreversible harm; therefore these patients may be especially motivated to use telemedicine to keep health care appointments during the pandemic.…”

mentioning

confidence: 90%

Evaluation of Telemedicine Use Among US Patients With Newly Diagnosed Cancer by Socioeconomic Status

Katz

Haynes

et al. 2022

JAMA Oncol

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mentioning

confidence: 90%

Evaluation of Telemedicine Use Among US Patients With Newly Diagnosed Cancer by Socioeconomic Status

Katz

Haynes

et al. 2022

JAMA Oncol

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“…In Italy, 20% of the teleconsultations carried out during the pandemic were telephone-based, 38% were conducted through web-based systems, 29% in specific platforms, and 13% via apps ( 6 ). By April 2020, telephone consultations in US outpatient centres accounted for 65.4% of primary care consultations and 71.6% of behavioural health visits ( 7 ).…”

Section: Introductionmentioning

confidence: 99%

The effectiveness of teleconsultations in primary care: systematic review

2021

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Background The COVID-19 pandemic has focussed attention on models of healthcare that avoid face-to-face contacts between clinicians and patients, and teleconsultations have become the preferred mode of primary care delivery. However, the effectiveness of remote consultations in this setting remains unclear. Objective To evaluate the impact of telephone or video consultations compared to those conducted face-to-face on key patient-relevant outcomes and healthcare utilisation in primary care, mental health and allied health services, which have had a critical role in the management of the wider and longer-term consequences of COVID-19. Methods A systematic review of primary studies comparing telephone or video consultations versus face-to-face visits, following the PRISMA guidelines. Results Overall, consultations delivered by telephone and videoconference were as effective as face-to-face in-person visits to improve clinical outcomes in adults with mental health conditions and those attending primary care services. Patient satisfaction with telephone and video consultations and the therapeutic alliance was high across the studies. However, high discontinuation rates in patients receiving teleconsultations indicate this may not be a suitable modality of healthcare delivery for all patients. Teleconsultations offer significant patient time savings in primary care, but appropriate implementation, including training of healthcare professionals and management of technical issues, is essential to ensure effective and valuable clinical interventions. Conclusions Teleconsultations via telephone or videoconference are an effective alternative to face-to-face consultations for many patients attending primary care and mental health services. Teleconsultations have the potential to deliver time-efficient and lower-cost interventions at a distance while improving access to healthcare.

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“…pandemic provided examples of troubling barriers to digital health access, such as low uptake of video visits among underserved populations 2 and disproportionate barriers to access to online vaccination appointments for communities most affected by the pandemic. These gaps reflect both structural deficiencies within the digital infrastructure in the US as well as a lack of attention to equity within the development and implementation of digital platforms and solutions.…”

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confidence: 99%

Focusing on Digital Health Equity

Lyles

Wachter

Sarkar

2021

JAMA

152

101

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The disproportionate toll of the COVID-19 pandemic on Black, Hispanic/Latinx, and lower-income communities highlighted long-standing disparities in health and health care. Addressing these disparities requires fundamental changes to health care delivery; more equitable outcomes will not be achieved without changing the underlying system.The renewed focus on health equity comes at a time of rapid digital transformation of the health care system. This transformation offers an opportunity to address many core health equity challenges. Digital health involves digitally enabled tools and environments to augment in-person health care with digital communication, education, and remote care management. These approaches have the potential to address some of the structural challenges for marginalized populations, including lowering access barriers of time and distance and providing tailored communication by language and literacy. Yet the digitization of health care can also harm health equity if this digitally enabled ecosystem moves forward without proactive engagement, planning, and implementation.Digital access and skills are foundational social determinants of health, 1 as effective use of both social services (including educational, housing, and other resources) and health care information (such as patient medical records) are increasingly moving online. The

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Telehealth Use Among Safety-Net Organizations in California During the COVID-19 Pandemic

Cited by 116 publications

References 1 publication

Evaluation of Telemedicine Use Among US Patients With Newly Diagnosed Cancer by Socioeconomic Status

Evaluation of Telemedicine Use Among US Patients With Newly Diagnosed Cancer by Socioeconomic Status

The effectiveness of teleconsultations in primary care: systematic review

Focusing on Digital Health Equity

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