Need For Interpreter Impedes Access to Telemedicine

When evaluating the utilization of telemedicine during the COVID-19 pandemic, a study presented at the 2021 North American Neuro-Ophthalmology Society Annual Meeting cited several barriers underserved communities may face and found that Hispanic patients who were not proficient in English were reported to have lower rates of telehealth visits. 

Previous studies have identified that underserved communities are underutilizing telemedicine, and this study uncovered more about the differences between patients who opt to use telehealth and those who would prefer in-person visits, and what barriers currently exist for these patients.

The researchers note that, while telehealth can improve efficiency and decrease the need for patients to travel long distances for appointments, ophthalmology itself has significant barriers to remote evaluation. Though, for select patients, it can be a useful tool for triage, diagnostic consultation, and long-term monitoring. 

In this retrospective, observational clinical study, patients from a single neuro-ophthalmology provider at a tertiary care academic center were evaluated. Data was pulled from March 15, 2020 to June 15, 2020 to represent the beginning of the pandemic and lockdown safety measures were implemented. 

If patients were seen for workers’ compensation, disability, independent medical exams or for pre- or post-operation, they were excluded from the study. 

Out of the 185 patients evaluated in this study, 56.77% of their visits during this 3-month period were via synchronous telehealth. The results show that patients who had telehealth visits and those who had in-person visits were similar in age, gender, type of insurance, distance from their home to their provider, visit type (new vs follow up), and diagnosis. 

Both groups were also similar in terms of access, such as living in a healthcare provider shortage area, medically underserved area, and the number of broadband providers. 

The most profound finding was patients who need an interpreter are the most likely to prefer in-person visits. The researchers explain that while telehealth does often allow for interpretation, most features on the interface itself are only available in English. Also, most asynchronous patient communication is exclusively in English.

While broadband availability wasn’t a factor, other technology-related barriers need to be further characterized, such as access to adequate video capabilities and various levels of digital literacy. 

Since telemedicine is becoming more popular as a result of the COVID-19 pandemic, and it has the potential to increase access to care, researchers suggest that it would be prudent for practitioners to be aware of potential barriers and disparities so that they can be addressed.

Reference

Villegas N, Gutierrez K, Chauhan D, et al. Telehealth in neuro-ophthalmology at a tertiary care academic medical center during the COVID-19 pandemic. Presented at: North American Neuro-Ophthalmology Society Annual Meeting; February 20-23, 2021; Poster 79.