Telehealth Less Commonly Used Among Certain Vulnerable Populations

Certain vulnerable populations with cancer may have reduced uptake of telehealth, especially video modalities.

“During the SARS-CoV-2 pandemic, cancer healthcare rapidly transitioned towards reliance on telehealth as the default so as to minimize risk of SARS-CoV-2 infection for patients and providers,” study researchers wrote. “This rapid shift may have simplified care logistics and improved care convenience for many patients … At the same time, it is also possible that telehealth inadvertently exacerbated existing disparities in healthcare for some vulnerable populations.”

Researchers at a designated comprehensive cancer center in Minnesota reviewed visits by cancer survivors between January and December 2020. Of 159,301 visits, 33,242 were telehealth visits.

The researchers found that older and rural-dwelling individuals were underrepresented in telehealth visits compared with in-person care.

About two-third of telehealth visits were among those aged 18-49, and telehealth visits were less common among rural compared with urban residents (43% vs. 53%).

Patients that were aged older than 70, rural residents, and most patient groups of color used video for only between 33% to 43% of their telehealth visits.

“One compelling finding of this study is that the relative participation of rural (compared with urban) patients in any kind of telehealth was lower than their relative participation among in-person care,” the researchers wrote. “This finding is relevant since telehealth has been previously described as one potential approach to mitigate rural healthcare shortages that exist independently of the SARS-CoV-2 pandemic, and to improve care logistics, for example travel times.”

The study also showed less telehealth use among certain cancer types, including hematologic malignancies.

Based on these results, the researchers concluded that a “one-size-fits-all approach” may not be feasible going forward.

“Future research should evaluate potential underlying contributors to the observed disparities such as technology and internet access, fear of discrimination, and barriers that exist at the provider versus patient level,” they wrote.