Improving Specialty Care Access via Telemedicine.

Area of Science:

• Health Services Research
• Digital Health
• Health Equity

Background:

• Telehealth (TM) presents a solution to healthcare access disparities by overcoming structural barriers.
• Adoption and characterization of TM in urban underserved settings remain limited.

Purpose of the Study:

• To evaluate the effectiveness and patient satisfaction of TM for specialty care in an urban underserved setting.
• To compare clinical outcomes and visit attendance between TM and traditional in-person visits.

Main Methods:

• Prospective cohort study involving patients with diabetes, hypertension, and/or kidney disease at a Federally Qualified Health Center (FQHC).
• Comparison of clinical outcomes with matched controls receiving in-person care.
• Analysis of no-show rates for TM versus standard (STD) in-person visits and patient satisfaction surveys.

Main Results:

• No significant difference in no-show rates between TM and STD visits (adjusted odds ratio: 1.03, p=0.87).
• Equivalent clinical outcomes in TM versus control groups for mean arterial pressure, serum creatinine, and estimated glomerular filtration rate.
• A trend towards significant reduction in hemoglobin A1c (p=0.053) and high patient satisfaction with TM.

Conclusions:

• Telehealth demonstrated improved glycemic control and equivalent management of hypertension and kidney disease.
• High patient satisfaction supports the use of TM to improve healthcare access for urban underserved populations.
• Findings support expanding TM availability to address persistent health disparities.