Demographic disparities persist in video visit utilization

Older adults and Black individuals were far more likely to experience video visit failures than their peers, according to recently published research.

UC Davis Health researchers conducted the study to assess demographic disparities in synchronous telehealth video visits. They reviewed video visit telemetry data and EHR appointment information for scheduled video visits between Sept. 1, 2020, and Nov. 30, 2020. They included various types of demographic information for each visit, including age, sex, race and primary language spoken. The study results were published in the American Journal of Managed Care earlier this month.

Researchers had access to data for 30,996 of the 47,065 scheduled video visits during the study period. The vast majority (87.9%) of these visits were successful, while the rest were listed as failed.

The failed video visits included visits with telemetry data, but no indication of a simultaneous connection, and visits changed to audio-only telephone encounters after a video connection attempt.

After adjusting for other baseline demographic variables, the researchers found that patients older than 65 were 102% more likely to experience a failed video visit than those younger than 65. Further, Black patients were 56% more likely to have a failed video visit than white patients. Similarly, Hispanic/Latino patients were 16% more likely to have a failed video visit than those of other ethnicities.

However, Asian patients were 19% less likely to have a failed video visit than those who were not Asian.

"Using video visit telemetry to understand the patterns of failure can support more targeted interventions to improve the quality and success of telehealth visits…Having access to technical success data correlated to demographics, as in this study, can target these interventions to have the greatest impact," the researchers concluded.

The study is not the first to show that sociodemographic factors influence video visit success.

Back in 2021, a study published in JAMA Network Open showed that Black patients and those between 66 and 80 were more likely to have video visits transferred to a telephone service. The study included 137,846 video visits for primary and specialty care between March 1 and Dec. 31, 2020.

More recently, research showed that limited English proficiency is linked to telehealth access challenges and subpar video visit experiences. For the study, researchers assessed data from the 2021 California Health Interview Survey. They found that patients with limited English proficiency were less likely to use telehealth and more likely to rate video visit experience as worse than in-person appointments compared to their peers who can speak English proficiently. 

While research into strategies to close gaps in video visit utilization is ongoing, one 2022 study showed that medical assistants could work with patients to connect to video visits successfully.

The study assessed Permanente Medical Group's virtual rooming initiative, which involves a medical assistant calling the patient 15 minutes before the telehealth appointment to help connect them to the video visit. The researchers found that patients receiving care at medical offices with high virtual rooming rates were 7% more likely to connect successfully to the video visit.

Anuja Vaidya has covered the healthcare industry since 2012. She currently covers the virtual healthcare landscape, including telehealth, remote patient monitoring and digital therapeutics.