Association of Patient Characteristics With Delivery of Ophthalmic Telemedicine During the COVID-19 Pandemic.

Published on Sep 23, 2021in JAMA Ophthalmology7.389
路 DOI :10.1001/JAMAOPHTHALMOL.2021.3728
Kanza Aziz3
Estimated H-index: 3
(JHUSOM: Johns Hopkins University School of Medicine),
Jade Y Moon2
Estimated H-index: 2
(MEE: Massachusetts Eye and Ear Infirmary)
+ 4 AuthorsGrayson W. Armstrong10
Estimated H-index: 10
(MEE: Massachusetts Eye and Ear Infirmary)
Sources
Abstract
Importance null Telemedicine has been shown to have had reduced uptake among historically marginalized populations within multiple medical specialties during the COVID-19 pandemic. An evaluation of health disparities among patients receiving ophthalmic telemedical care during the pandemic is needed. null Objective null To evaluate disparities in the delivery of ophthalmic telemedicine at Massachusetts Eye and Ear (MEE) during the COVID-19 pandemic. null Design, setting, and participants null This retrospective, cross-sectional study analyzed clinical visits at a single tertiary eye care center (MEE) from January 1 to December 31, 2020. Patients who had ophthalmology and optometry clinical visits at the MEE during the study period were included. null Exposures null Telemedicine vs in-person clinical encounters. null Main outcomes and measures null Variables associated with use of ophthalmic telemedicine during the study period. null Results null A total of 2262 telemedicine ophthalmic encounters for 1911 patients were included in the analysis. The median age of the patients was 61 (interquartile range, 43-72) years, and 1179 (61.70%) were women. With regard to race and ethnicity, 87 patients (4.55%) identified as Asian; 128 (6.70%), as Black or African American; 23 (1.20%), as Hispanic or Latino; and 1455 (76.14%), as White. On multivariate analysis, factors associated with decreased receipt of telemedical care included male sex (odds ratio [OR], 0.86; 95% CI, 0.77-0.96), Black race (OR, 0.69; 95% CI, 0.56-0.86), not speaking English (OR, 0.63; 95% CI, 0.48-0.81), educational level of high school or less (OR, 0.83; 95% CI, 0.71-0.97), and age (OR per year of age, 0.99; 95% CI, 0.989-0.998). When comparing telephone- and video-based telemedicine visits, decreased participation in video-based visits was associated with age (OR per year of age, 0.96; 95% CI, 0.94-0.98), educational level of high school or less (OR, 0.54; 95% CI, 0.29-0.99), being unemployed (OR, 0.28; 95% CI, 0.12-0.68), being retired (OR, 0.22; 95% CI, 0.10-0.42), or having a disability (OR, 0.09; 95% CI, 0.04-0.23). null Conclusions and relevance null The findings of this cross-sectional study, though limited to retrospective data from a single university-based practice, suggest that historically marginalized populations were less likely to receive ophthalmic telemedical care compared with in-person care during the first year of the COVID-19 pandemic in the US. Understanding the causes of these disparities might help those who need access to virtual care.
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#1David S. Portney (UM: University of Michigan)H-Index: 3
#2Ziwei Zhu (UM: University of Michigan)H-Index: 2
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Telehealth usage peaked at 17% of encounters (4/5-4/11/20) and then declined, accounting for 1.6% (2,031) of the 127,028 ophthalmic visits from 3/15/2020-9/1/2020. Telehealth was disproportionately used for visits related to cornea and external disease diagnoses.
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#1Kara Wegermann (Duke University)H-Index: 5
#2Julius M. Wilder (Duke University)H-Index: 9
Last. Yuval A. Patel (Duke University)H-Index: 11
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BACKGROUND AND AIMS The coronavirus disease 2019 (COVID-19) pandemic resulted in a rapid expansion of telehealth services in hepatology. However, known racial and socioeconomic disparities in internet access potentially translate into barriers for the use of telehealth, particularly video technology. The specific aim of this study was to determine if disparities in race or socioeconomic status exist among patients utilizing telehealth visits during COVID-19. METHODS We performed a retrospective ...
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Objective Through the coronavirus disease 2019 (COVID-19) pandemic, telemedicine became a necessary entry point into the process of diagnosis, triage and treatment. Racial and ethnic disparities in health care have been well documented in COVID-19 with respect to risk of infection and in-hospital outcomes once admitted, and here we assess disparities in those who access healthcare via telemedicine for COVID-19 . Materials and methods Electronic health record data of patients at New York Universi...
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#1Jade Y Moon (MEE: Massachusetts Eye and Ear Infirmary)H-Index: 2
#2John B. MillerH-Index: 23
Last. Grayson W. ArmstrongH-Index: 10
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Purpose: During the COVID-19 pandemic, there is growing concern that patients are forgoing necessary care. Emergency departments (ED) represent an important site of eye care. We analyzed patterns of ED visits at an eye-specific ED since the declaration of the public health crisis. Materials and Methods: In this retrospective, cross-sectional single center study, medical records of 6744 patients who presented to the Massachusetts Eye and Ear ED between March 1st and April 30th in 2018, 2019, and ...
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#10Samuel U Takvorian (HUP: Hospital of the University of Pennsylvania)H-Index: 7
Importance The coronavirus disease 2019 (COVID-19) pandemic has required a shift in health care delivery platforms, necessitating a new reliance on telemedicine. Objective To evaluate whether inequities are present in telemedicine use and video visit use for telemedicine visits during the COVID-19 pandemic. Design, Setting, and Participants In this cohort study, a retrospective medical record review was conducted from March 16 to May 11, 2020, of all patients scheduled for telemedicine visits in...
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#1Christopher H. Schifeling (University of Colorado Denver)H-Index: 3
#2Prajakta Shanbhag (University of Colorado Denver)H-Index: 4
Last. Hillary D. Lum (University of Colorado Denver)H-Index: 20
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Background Telephone and video telemedicine appointments have been a crucial service delivery method during the COVID-19 pandemic to maintain access to healthcare without increasing risk of exposure. While pre-pandemic studies suggest that telemedicine is an acceptable format for older adults, there is a paucity of data on the practical implementation of telemedicine visits. Due to prior lack of reimbursement for telemedicine visits involving non-rural patients, no studies have compared telephon...
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#1Robert P. Pierce (MU: University of Missouri)H-Index: 3
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IntroductionThe coronavirus disease 2019 (COVID-19) pandemic resulted in an unprecedented expansion in telehealth, but little is known about differential use of telehealth according to demographics...
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Ophthalmology, an outpatient surgical specialty, depends on regular in-person encounters to manage complex eye disease. The coronavirus disease 2019 (COVID-19) pandemic has brought about unprecedented challenges in how we take care of our patients. At Vanderbilt University Medical Center, we have gone to great lengths to implement expeditiously a telemedicine platform for safely and securely evaluating our patients during the pandemic. Since implementing live videoconference appointments in late...
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#1Swan Kang (Moorfields Eye Hospital)
While the Covid-19 pandemic poses an unprecedented challenge to ophthalmic service delivery, it also creates a unique opportunity to rapidly expand and promote new uses of telemedicine. Telemedicine offers distinct benefits to patients, clinicians, and communities during the current crisis: it supports social distancing measures by minimising the need for patients and clinicians to travel to hospitals; it enables continued service delivery at a time when in-person outpatient activity has been se...
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#1Christopher J. Hwang (UNC: University of North Carolina at Chapel Hill)H-Index: 3
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BACKGROUND: Skype video telemedicine consults are gaining popularity to evaluate patients from distant locations. No study has analyzed the utility of this means of patient evaluation in a cosmetic oculoplastic patient population. OBJECTIVES: The authors sought to provide an evidence-based analysis of the utility of Skype video consults in a cosmetic oculoplastic surgery patient population with regards to patient demographics, reasons for consult, and procedural conversion rate. METHODS: A 1-yea...
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