A study by the UCLA Latino Policy and Politics Institute found that since the onset of COVID-19, language barriers have prevented Latino and Asian patients in Los Angeles from making full use of telehealth services.
The study also found that black and white patients had an easier time with video visits — and that some older patients and those with limited access to technology, especially Latinos, relied on family members to help them access telehealth services.
The study is based on data from a Los Angeles County health system: researchers analyzed patient visits from January to December 2020 and conducted surveys and interviews with 39 health care providers at seven of the health system’s clinics between August 2021 and April 2022.
The findings highlight the need for care providers to consider the roles that patients’ race, ethnicity, age, and primary language play in telehealth adoption.
This study is timely because in July 2022 the US House of Representatives approved a bill to extend Medicare reimbursements for telehealth visits until the end of 2024, and the US Senate is currently considering legislation that would direct more funding for telehealth visits to Medicare beneficiaries.
Improving the way telehealth services are deployed can help address the longstanding disparities in health care access and use that communities of color have faced. Arturo Vargas Bustamante, Professor of Health Policy and Management at the UCLA Fielding School of Public Health and Director of Faculty Research at the Latino Institute for Policy and Politics.
“For patients who may avoid medical appointments because of scheduling, lost wages or transportation challenges, telehealth offers the option of receiving medical care without leaving their home or workplace,” Bustamante said. “Our research found that while language and technology barriers persist, a hybrid approach, combining in-person visits and telehealth visits, has the potential to improve the patient and provider experience.”
Additional findings include:
- Health care providers of color were more likely than white providers to report that patients’ race and ethnicity influenced their use of telehealth services.
- The share of telehealth visits increased from 8% before the pandemic to nearly 48% almost immediately after California’s stay-at-home order went into effect in March 2020, demonstrating that telemedicine appointments were critical in helping patients get care, even when they were. Can’t go to the clinic.
- Telephone telehealth appointments (more than 80%) were much more common than video telehealth appointments. The percentage of patients who used videoconferencing varied by race and ethnicity.
- Patients continued to use telehealth for health-enhancing purposes—health classes and nutritional therapy, for example—even as pandemic restrictions eased in the second half of 2020.
“The pandemic is a crisis that has forced innovation in how to provide better health care, and as telehealth continues to be a significant way to receive care, it will be important to make sure that no one, regardless of age, race, origin or origin. The spoken language, is left behind,” said Diana Camach and, senior program officer for the California Health Foundation, which funded the study.
The authors of the study recommend that health systems and providers address the digital and technological barriers that patients face by investing in programs that provide technological support, both in person and remotely, to people who have difficulty navigating telehealth on their own. Furthermore, providers should support efforts to assign technology devices and Internet services to their patients.