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Best of the Best Gen Surg - Age Exacerbates Inequity in Telemedicine Use Among GI Surgery Patients in the Deep South During the COVID-19 Pandemic - Dr. Shao
With Dr. Connie Shaw & Dr. Mike Rosen · hosted by Dr. Todd Ponsky
Chapter 1 of 5 · Fundamentals
Study introduction
Introduction to telemedicine inequity study
Expert statements on this page
No expert statements were drawn from this page.
Host summaries · secondary, not cited in answers
Educational content from recorded physician discussions — not medical advice. Talk to your (or your child's) care team about your situation.
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What the experts said
Telemedicine visits at UAB started March 17, 2020
There were 2,580 GI surgery clinic visits at UAB from March 17 to September 30, 2020
Of all visits, half were in-person and half were via telemedicine
Of telemedicine visits, almost 60% were via phone
Among telemedicine users, Black patients were more likely to use phone compared to video visits
Among telemedicine users, those who used telephone visits were older, with a mean age of 54 years compared to 50 years for video users
Having an age greater than 80 independently predicted that the telemedicine visit would be without video with an odds ratio of 0.37
Phone users came from zip codes with lower median income, with a mean of $49,000 for phone visits and $51,000 for video visits
Those seen with telemedicine were more likely to be privately insured
Among telemedicine users, those who used phone calls were more likely to be publicly insured
Medicaid insurance was an independent predictor of having a telemedicine visit without video, with an odds ratio of 0.46
Patients who lived further from the hospital were 1.5 times as likely to use telemedicine
Among telemedicine users, those living further from the hospital were 2.3 times as likely to have a video visit
Local internet availability was not a significant factor in telemedicine use patterns
Telemedicine use was predicted by median income of the patient's zip code and distance to the hospital
Phone use was predicted by age, Medicaid insurance, and distance to the hospital
Patient satisfaction is lower for phone visits than any other type of visit
Patient satisfaction decreases with age, but only for phone calls, not for video calls
Satisfaction is lower for patients who must convert from a video to an audio-only call
Conversion rates from video to audio increase with age
Neither satisfaction nor conversion rates differ by race
UAB created a separate Wi-Fi network called UAB Telehealth specifically for physicians to use for reliable broadband during telemedicine visits
Phone calls are not reimbursed at the same rate as video-based telemedicine
UAB hospital system uses AW Touchpoint for telemedicine, which is integrated into the EMR
Doximity app is HIPAA-compliant and can be used on computer or phone without connecting to personal cell phone
Transportation is the number one reason why patients no-show to physician appointments