Although the COVID-19 pandemic accelerated the implementation of telemedicine, it is likely here to stay even beyond the pandemic, given its ability to improve access to care by reducing logistic barriers for patients like transportation, time taken off from work, and access for rural populations.1 The rapid adoption of telemedicine resulted in a 12% increase in telemedicine usage among practicing urologists.2 Wider use of telemedicine has potential to ameliorate the worsening workforce shortages in underserved areas that do not have practicing urologists.
Despite benefits of telehealth expansion, patients who are older, non-English speaking, and Asian, are less likely to complete outpatient telemedicine visits; patients who are older, female, Black, Latinx, and with lower socioeconomic status are less likely to utilize video visits vs telephone visits.3 , 4 In this study, Javier-DesLoges et al describe a single center's experience utilizing telemedicine for urology visits. The authors identified that patients who were Hispanic, older than age 55 years, and insured through Medicaid were less likely to utilize telemedicine vs in-person visits, and patients being evaluated for infertility were more likely to utilize telehealth visits.
Identifying and reporting these disparities within urology is commendable during this early stage of fully integrating telemedicine into the health care system. More permanent policy from the Center for Medicare & Medicaid Services for regulation and reimbursement of telemedicine is forthcoming. Consequently, interventions to bridge these emerging disparitiesshould accompany continued integration. This may include technical support for patient unfamiliar with video platforms, social services connecting patients with local free and low-cost internet services, and fully integrated, virtual translation services for non-English speaking patients. We must ensure equitable access to this technology early on in order to avoid deepening inequalities in health outcomes among already-vulnerable patient populations.
Footnotes
Financial Disclosure: The authors declare that they have no relevant financial interests.
Competing interests: The authors have no conflicts to disclose.
REFERENCES
- 1.Telehealth is here to stay. Nat Med. 2021;27 doi: 10.1038/s41591-021-01447-x. 1121-1121. [DOI] [PubMed] [Google Scholar]
- 2.American Urological Associtaion. 2020 The state of urology workforce and practice in the United States. Published online May 27, 2021.
- 3.Eberly LA, Kallan MJ, Julien HM, et al. Patient characteristics associated with telemedicine access for primary and specialty ambulatory care during the COVID-19 pandemic. JAMA Netw Open. 2020;3 doi: 10.1001/jamanetworkopen.2020.31640. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 4.Rodriguez JA, Saadi A, Schwamm LH, Bates DW, Samal L. Disparities in telehealth use among California patients with limited English proficiency. Health Affairs. 2021;40:487–495. doi: 10.1377/hlthaff.2020.00823. [DOI] [PubMed] [Google Scholar]