Disparities in telemedicine access for Spanish-speaking patients during the COVID-19 crisis

Area of Science:

• Dermatology
• Health Disparities
• Digital Health

Background:

• The COVID-19 pandemic accelerated the adoption of telemedicine.
• Concerns exist regarding telemedicine's potential to exacerbate existing health care disparities.
• Vulnerable populations may face unique challenges in accessing virtual care.

Purpose of the Study:

• To compare access to pediatric teledermatology for Spanish-speaking patients before and during the COVID-19 pandemic.
• To identify barriers contributing to reduced telemedicine access among this population.

Main Methods:

• Retrospective analysis of pediatric teledermatology visits.
• Comparison of appointment data from March 17, 2020–July 31, 2020 (pandemic) with the same period in 2019 (pre-pandemic).
• Evaluation of patient demographics, including language, and digital access indicators like email and patient portal utilization.

Main Results:

• Spanish-speaking patients had significantly fewer scheduled teledermatology appointments during the pandemic compared to the previous year (9% vs 5%, P < .001).
• Among telemedicine patients, Spanish-speaking individuals were less likely to have documented email addresses (45% vs 62%, P = .017) or active patient portal accounts (23% vs 66%, P < .001).

Conclusions:

• Email and patient portal access may be significant barriers for Spanish-speaking children seeking pediatric dermatology care via telemedicine.
• Digital divides can limit equitable access to virtual health services for minority populations.
• Interventions to improve digital literacy and access are crucial for inclusive telemedicine implementation.