Assistance With Connecting to Virtual Visits Can Help Close Care Gaps

Having medical assistants work with patients to connect to video visits could help narrow the digital divide, according to a new study conducted by Kaiser Permanente.

Published in JAMA Internal Medicine, the research assessed an initiative developed by the Permanente Medical Group to support video-based telehealth. The initiative included 'virtual rooming,' which involves a medical assistant calling the patient 15 minutes before the telehealth appointment to help connect them to the video visit.

Researchers examined data on telehealth visits from Oct. 1 through Oct. 31, 2020. They compared video visits in medical offices that used virtual rooming more often with those that did not use it as often.

Of the 136,699 video visits studied, 83.6 percent involved a successful connection to the video visit. The use of virtual rooming in medical offices varied, ranging from 4.6 percent to 97.2 percent.

Overall, patients receiving care at medical offices with high virtual rooming rates were 7 percent more likely to have a successful connection to the video visit.

After adjusting for patient factors such as age and comorbidities, the estimated connection rates for those who received assistance were 11.4 percent higher among patients who lived in low socioeconomic status neighborhoods, 12.1 percent higher among Black patients, 9.8 percent higher among Latino patients, and 13.1 percent higher among those who needed language interpretation.

"The involvement of a medical assistant seemed to reduce the technology gap,” said senior study author Mary Reed, DrPH, a research scientist with the Kaiser Permanente Division of Research, in the press release. "Our study didn't identify exactly how this happens, but we believe it is because the medical assistant is available to walk patients through the technology and provide encouragement and a human connection."

In addition to connecting patients to video visits, Kaiser Permanente is tasking medical assistants with determining the patient's main goal for a visit and whether preventive screenings are needed.

"Virtual rooming is really powerful because medical assistants have the chance to connect with patients in their homes," said Christine Levan, MD, regional director of performance improvement in primary care at Kaiser Permanente, in the press release. "To see the actual evidence and data of these benefits was remarkable and validating."

Telehealth use remains popular, even experiencing a boost amid the Omicron variant surge, but the digital divide is a clear barrier to the care modality.

A recent study found that Black patients with cardiovascular disease preferred recording their blood pressure via a text-based program rather than an online patient portal. Researchers stated that accessing "online patient portals may be prohibitive for patients from historically marginalized groups."

Researchers from Boston University and Boston Medical Center also recently examined the digital divide. They developed a three-pronged strategy to mitigate it: create federal and state policies to operationalize telehealth infrastructure, establish national standards for healthcare access portals, and support families as they adopt new care modalities.