Telemedicine and Health Disparities During COVID-19.

Abstract

* Abbreviations: ASL — : American Sign Language COVID-19 — : coronavirus disease 2019 ED — : emergency department The coronavirus disease 2019 (COVID-19) pandemic has resulted in rapid and large-scale expansion of telemedicine. At a time when physical contact with the medical system poses a risk of infection, telemedicine offers a vehicle for delivering medical care at a safe social distance. It allows for attention to acute concerns as well as routine screening for medical and social needs, which may be heightened during this time. For families with limited resources, telemedicine offers particular advantages, obviating the need for transportation, child care, and additional time needed for in-person office visits. For these reasons, telemedicine has been proposed as a solution to health care inequities in the past and implemented with success in select populations.1 Although the promise of telemedicine is an expansion of access, reliance on technology is likely to highlight existing vulnerabilities and widen disparities if precautions are not taken. Previous reports have outlined how technology-based solutions are highly susceptible to intervention-generated inequalities driven by underlying inequalities in access and uptake.2 Because rollout of telemedicine on this scale is unprecedented, the use of telemedicine in ambulatory settings during this time may illuminate important lessons for the field of telemedicine as a whole. As medical systems have shifted resources … Address correspondence to Michelle W. Katzow, MD, MS, 410 Lakeville Rd, Suite 311, New Hyde Park, NY 11040. E-mail: mkatzow{at}northwell.edu