Historically, there has been racial inequity when it comes to primary care appointments, which are vital for managing and preventing chronic disease. But as COVID-19 struck the United States in 2020 and telemedicine availability rose sharply, gaps in access disappeared for Black patients at Penn Medicine, new research from the Perelman School of Medicine shows. These findings are published in Telemedicine and e-Health.
“We looked through the entire year of 2020, not just the first half of the year when telemedicine was the only option for many people, and the appointment completion gap between Black and non-Black patients closed,” says the study’s senior author, Krisda Chaiyachati, an assistant professor of medicine at Penn Medicine and the physician lead for Value-based Care and Innovation at Verily. “Offering telemedicine, even though it was for a crisis, appears to have been a significant step forward toward addressing long-standing inequities in healthcare access.”
COVID-19’s sudden onset in early 2020 resulted in a telemedicine boom. Use of it had typically been narrow, largely as a result of regulations and hesitancy among payers, but emergency provisions allowed health care entities to quickly conduct appointments via phone or computer. There was some concern that these developments, while good for preventing the spread of COVID, might adversely impact racial and ethnic groups who have been historically underserved by health care.
That’s why Chaiyachati—who headed Penn Medicine’s virtual visit service, Penn Medicine OnDemand, through most of the pandemic—and his fellow researchers decided to focus on whether Black patients at Philadelphia-area practices were able to see their primary care providers as often in 2020 as they had in 2019, and then compare those numbers to non-Black patients (which, in this population, mainly consists of white, non-Hispanic people). Data from roughly 1 million appointments in each year were analyzed.
Findings from this analysis showed that completed primary care visits rose from approximately 60% among Black patients before the arrival of COVID-19 to over 80% in 2020. To compare, non-Black patients visit completion rate was in the 70% range prior to COVID-19, then was also over 80% in 2020. The equity gap of at least 10% disappeared at Penn Medicine practices after the pandemic arrived, when telemedicine was widely adopted.
“The specific time periods where we saw significant gains made by Black patients came when telemedicine was well-established in our health system,” Chaiyachati says. “This does not appear to be a coincidence.”
This story is by Frank Otto. Read more at Penn Medicine News.
