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      Telehealth Use by Age and Race at a Single Academic Medical Center During the COVID-19 Pandemic: Retrospective Cohort Study

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          Abstract

          Background

          During the COVID-19 pandemic, many ambulatory clinics transitioned to telehealth, but it remains unknown how this may have exacerbated inequitable access to care.

          Objective

          Given the potential barriers faced by different populations, we investigated whether telehealth use is consistent and equitable across age, race, and gender.

          Methods

          Our retrospective cohort study of outpatient visits was conducted between March 2 and June 10, 2020, compared with the same time period in 2019, at a single academic health center in Boston, Massachusetts. Visits were divided into in-person visits and telehealth visits and then compared by racial designation, gender, and age.

          Results

          At our academic medical center, using a retrospective cohort analysis of ambulatory care delivered between March 2 and June 10, 2020, we found that over half (57.6%) of all visits were telehealth visits, and both Black and White patients accessed telehealth more than Asian patients.

          Conclusions

          Our findings indicate that the rapid implementation of telehealth does not follow prior patterns of health care disparities.

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          Most cited references10

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          Telehealth and patient satisfaction: a systematic review and narrative analysis

          Background The use of telehealth steadily increases as it has become a viable modality to patient care. Early adopters attempt to use telehealth to deliver high-quality care. Patient satisfaction is a key indicator of how well the telemedicine modality met patient expectations. Objective The objective of this systematic review and narrative analysis is to explore the association of telehealth and patient satisfaction in regards to effectiveness and efficiency. Methods Boolean expressions between keywords created a complex search string. Variations of this string were used in Cumulative Index of Nursing and Allied Health Literature and MEDLINE. Results 2193 articles were filtered and assessed for suitability (n=44). Factors relating to effectiveness and efficiency were identified using consensus. The factors listed most often were improved outcomes (20%), preferred modality (10%), ease of use (9%), low cost 8%), improved communication (8%) and decreased travel time (7%), which in total accounted for 61% of occurrences. Conclusion This review identified a variety of factors of association between telehealth and patient satisfaction. Knowledge of these factors could help implementers to match interventions as solutions to specific problems.
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            Impact of the digital divide in the age of COVID-19

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              Implications for Telehealth in a Postpandemic Future: Regulatory and Privacy Issues

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                Author and article information

                Contributors
                Journal
                J Med Internet Res
                J Med Internet Res
                JMIR
                Journal of Medical Internet Research
                JMIR Publications (Toronto, Canada )
                1439-4456
                1438-8871
                May 2021
                20 May 2021
                20 May 2021
                : 23
                : 5
                : e23905
                Affiliations
                [1 ] Center for Healthcare Delivery Science Beth Israel Deaconess Medical Center Boston, MA United States
                [2 ] Harvard Medical Faculty Physicians Beth Israel Deaconess Medical Center Boston, MA United States
                [3 ] Information Systems, Beth Israel Deaconess Medical Center Boston, MA United States
                Author notes
                Corresponding Author: Jennifer P Stevens jpsteven@ 123456Bidmc.harvard.edu
                Author information
                https://orcid.org/0000-0002-9880-9662
                https://orcid.org/0000-0002-8567-0534
                https://orcid.org/0000-0001-7720-4683
                https://orcid.org/0000-0001-7401-5692
                https://orcid.org/0000-0001-9405-0479
                Article
                v23i5e23905
                10.2196/23905
                8139390
                33974549
                84f31a85-3142-487a-8720-288bb3b3861a
                Jennifer P Stevens, Oren Mechanic, Lawrence Markson, Ashley O'Donoghue, Alexa B Kimball. Originally published in the Journal of Medical Internet Research (https://www.jmir.org), 20.05.2021.

                This is an open-access article distributed under the terms of the Creative Commons Attribution License ( https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in the Journal of Medical Internet Research, is properly cited. The complete bibliographic information, a link to the original publication on https://www.jmir.org/, as well as this copyright and license information must be included.

                History
                : 27 August 2020
                : 2 October 2020
                : 13 October 2020
                : 25 March 2021
                Categories
                Short Paper
                Short Paper

                Medicine
                access,barrier,cohort,covid-19,demographic,equity of care,equity,outpatient,telehealth
                Medicine
                access, barrier, cohort, covid-19, demographic, equity of care, equity, outpatient, telehealth

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