How limited english proficiency impacts patient engagement with telemedicine: a systematic review

Since the COVID-19 pandemic, telemedicine has become increasingly prevalent in healthcare delivery. While telemedicine holds promise to improve health equity, it may exacerbate pre-existing disparities for patients, including those with limited English proficiency (LEP). We systematically reviewed studies examining telemedicine utilization by LEP and English proficient (EP) patients in the United States. Four databases were searched, and 17 studies were included in this review. Among the seven studies analyzing overall utilization of telemedicine, five reported significantly lower utilization for patients with LEP than those with EP. Similarly, five out of seven studies investigating the utilization of telemedicine over in-person visits found lower telemedicine utilization for LEP patients. All seven studies analyzing telemedicine utilization by modality found significantly lower video use for patients with LEP than those with EP. Future work should address access to technology, digital literacy, healthcare system preparedness, and adequate interpreter accessibility.