27640 Disparities in telemedicine access for Spanish-speaking pediatric patients

Abstract

The COVID-19 pandemic forced dermatology practices to quickly transition to remote care via telemedicine, and with this change came the prospect of worsening health care disparities for vulnerable populations. To explore this possibility among the pediatric population in our urban academic dermatology practice, we retrospectively compared pediatric teledermatology visits scheduled during the pandemic (03/17/2020-07/31/2020, n = 1078) to in-person appointments scheduled in 2019 (03/17/2019-07/31/2019, n = 3442). Differences were analyzed using chi-squared tests. Hispanic and Spanish-speaking patients scheduled significantly fewer appointments during the pandemic compared with 2019 (20% vs 13%, P < .0001 and 9% vs 5%, P < .0001, respectively). Among the telemedicine cohort, Spanish-speaking patients were much less likely than non–Spanish-speaking patients to have an email address documented within the electronic medical record (EMR, 2.2% vs 58.7%, P = .017). An even smaller proportion of Spanish-speaking patients had activated an online patient portal account prior to their telemedicine visit (1.1% vs 63.0%, P < .0001). Hispanic patients are less likely to receive dermatologic care, and telemedicine could amplify this disparity. During the pandemic, much of our department’s communications have occurred through the patient portal. Our findings suggest that electronic connectedness may represent a bottleneck in telemedicine access for Spanish-speaking pediatric dermatology patients. By presenting the experience at our single institution, we wish to spur dialogue within our specialty to understand and address barriers to pediatric dermatology access in the era of telemedicine.