Disparities Exist in Telehealth Access Among Thoracic Cancer Patients

A study published in JAMA Network Open found that during the rapid increase in telehealth use during the COVID-19 pandemic, many thoracic cancer patients experienced disparities in telehealth access, particularly those who were Black, covered by Medicaid, and residing in a location with high cancer mortality rates.

To determine whether the inconsistent outcomes of thoracic cancer patients correlated with telehealth disparities, researchers collected data from patients who received care at the thoracic oncology division of Johns Hopkins Medical Institute in Baltimore.

The data included in the study covered 720 patients with thoracic cancer, representing 1,940 visits total. Of these visits, 1,261 occurred through telehealth, and 679 were in-person. Demographics such as age, sex, ethnicity, insurance coverage, and location of residency varied among patients.

Overall, researchers concluded that 56.86 percent of telehealth visits were successful. Patients who were Black, on Medicaid, or lived in a zip code with an elevated risk of cancer mortality were less likely to have successful telemedicine visits. 

The study also showed that those who participated in even one telehealth visit defined as unsuccessful were more likely to experience an emergency department visit or hospitalization.

However, those who experienced all successful telehealth visits or only one unsuccessful telehealth visit reported lower mortality rates compared to those only participating in in-person visits.

The study's main finding was that there were pronounced disparities in telehealth use among disadvantaged thoracic cancer patients.

"Telemedicine should be used to provide more health care access to individuals who are otherwise disadvantaged, and new digital health innovations should serve to decrease the digital divide rather than add to it," the researchers concluded. "Future studies that longitudinally assess the association between sociodemographic factors, telemedicine access, and clinical outcomes may serve as a foundation for more personalized care and development of targeted, risk-adapted interventions for those at risk of inferior health outcomes."

The rapid implementation of telehealth during the COVID-19 pandemic provided many benefits but also highlighted various disparities in healthcare.

For example, a study from April showed that Black and Hispanic patients had a lower rate of telehealth use compared with White patients. This is mainly due to the digital divide, which often results in racial minorities lacking access to the necessary technology.

Another study published in June indicated that missed pediatric telehealth visits often had a connection with economic disadvantages. This is likely due to the struggles those with a lower socioeconomic status face when obtaining telehealth tools.

However, many federally qualified health centers, which typically serve vulnerable populations, are attempting to counter the digital divide.

Some are employing telehealth navigators, community health workers, and patient experience navigators to help mitigate telehealth access barriers, and others are working to extend intent connectivity to underserved populations.