Unveiling Racial Disparities in Telemedicine Use

Telemedicine has been envisioned as a way to improve access to care for disadvantaged groups. However, the research on racial and ethnic disparities in telemedicine use is conflicting. Some studies have found lower use among minorities, others have found the opposite trend.

A recent study authored by Department of Health Care Policy professors, Sharon-Lise Normand, Haiden Huskamp, Alisa Busch, Ateev Mehrotra and colleagues in JAMA Health Forum investigates whether there were differences in the use of telemedicine services by race and ethnicity. The cross-sectional study included individuals who were continuously enrolled in traditional Medicare from March 2020 to February 2022 or until death. They categorized race and ethnicity as Black non-Hispanic, Hispanic, White non-Hispanic, other (defined as American Indian/Pacific Islander, Alaska native, and Asian, and unknown/missing). 

The initial, unadjusted results showed Black, Hispanic, and other racial and ethnic groups tended to use more telemedicine visits compared to White individuals. However, after considering factors like demographics, health conditions, and geographic location, the pattern reversed. Black, Hispanic, and other racial and ethnic groups had fewer total visits (telemedicine and in-person combined) compared to White individuals.

The study suggests that where people live could play a pivotal role in differences in telemedicine use by race and ethnicity. Areas with higher telemedicine adoption (urban areas with large healthcare systems) might have a larger population of racial and ethnic minorities, but within those areas, they might use it less than White neighbors. This could explain why some studies using data from single health systems found lower telemedicine use by minorities.

Telemedicine has the potential to improve access to care, though equitable implementation is key. Policies such as higher reimbursement in minority communities, partnering with community organizations, and investing in digital literacy programs can help bridge the gap. Further research and testing will be needed to focus these interventions.