Primary care telemedicine during the COVID-19 pandemic: patient's choice of video versus telephone visit.

• Type of Material: Article
• Authors: Jie Huang, Kaiser Permanente, California; Ilana Graetz, Emory University; Andrea Millman, Kaiser Permanente, California; Anjali Gopalan, Kaiser Permanente, California; Catherine Lee, Kaiser Permanente, California; Emilie Muelly, The Permanente Medical Group, Oakland, California, USA.; Mary E Reed, Kaiser Permanente, California
• Language: English
• Date: 2022-04
• Publisher: Oxford University Press
• Publication Version: Final Published Version
• Copyright Statement: © The Author(s) 2022. Published by Oxford University Press on behalf of the American Medical Informatics Association.
• License: Creative Commons Attribution-NonCommercial 4.0 International
• Final Published Version (URL): http://dx.doi.org/10.1093/jamiaopen/ooac002
• Title of Journal or Parent Work: JAMIA Open
• Volume: 5
• Issue: 1
• Start Page: ooac002
• End Page: ooac002
• Grant/Funding Information: This work was supported by the Agency for Healthcare Research and Quality (grant number R01HS025189).
• Keywords: access to care; telemedicine; video visit; COVID-19; digital divide
• Research Categories: Health Sciences, Health Care Management

Abstract

The aim of this study is to examine the association between patient characteristics and primary care telemedicine choice among integrated delivery system patients self-scheduling visits during the COVID-19 pandemic. We used multivariate logistic regression to examine the association between the choice of video versus telephone and patient sociodemographic characteristics and technology access among patient-initiated primary care telemedicine visits scheduled online from March to October 2020. Among 978 272 patient-scheduled primary care telemedicine visits, 39% were video visits. Patients of Black or Hispanic race/ethnicity, or living in low socioeconomic status or low internet access neighborhoods were less likely to schedule video visits. Patients 65 years or older, with prior video visit experience or mobile portal access, or visiting their own personal provider were more likely to schedule video visits. While video adoption was substantial in all patient groups examined, differences in telemedicine choice suggest the persistence of a digital divide, emphasizing the importance of maintaining a telephone telemedicine option.