Patient-Centered Communication in Telehealth Settings

Area of Science:

• Health Services Research
• Telehealth Communication
• Health Equity

Background:

• Patient-centered communication (PCC) is crucial for high-quality healthcare.
• PCC in telehealth remains understudied, particularly concerning disparities.
• The Minority Health Social Vulnerability Index (MHSVI) identifies counties vulnerable to public health emergencies.

Purpose of the Study:

• To examine associations between individual characteristics and optimal PCC in telehealth.
• To assess if these associations differ based on county-level vulnerability (MHSVI).

Main Methods:

• Cross-sectional online survey of adults (18+) in MHSVI least- or most-vulnerable US counties.
• Data collected Feb-Aug 2022 from 2754 participants with recent telehealth visits.
• Multivariable logistic regression analyzed self-reported optimal PCC items, stratified by MHSVI.

Main Results:

• Optimal PCC varied, with 38.8% reporting sufficient clinician time and 49.8% reporting clinician-ensured understanding.
• Lower odds of optimal PCC were linked to lower educational attainment and non-English proficiency.
• Higher odds of optimal PCC were associated with digital health literacy.
• PCC was comparable across racial/ethnic groups but differed by MHSVI vulnerability.
• Black/African American participants had lower odds of optimal time in most-vulnerable counties but higher odds of explained information in least-vulnerable counties.

Conclusions:

• Optimal PCC in telehealth was comparable across racial and ethnic groups.
• Educational attainment and English proficiency were associated with variations in optimal PCC.
• Findings suggest telehealth can facilitate optimal PCC, with differing impacts based on county vulnerability.