A recent study of the success of telemedicine at the University of Pennsylvania, looking at virtual visits during the early months of the COVID pandemic, found that disparities in participation by age and ethnicity were increased from “normal” medical practice. Of 150,000 people who had telemedicine appointments, only 54% completed the virtual visits. Telemedicine may in fact be exacerbating the economic and racial disparities in medical care.

The shift to telemedicine during the pandemic was rapidly forced upon the medical community at that time, although the trend toward such virtual medical visits had been slowly increasing even before the pandemic. The study reflected that older age, foreign ethnicity, and a lower socioeconomic status led to more patients not showing up for their scheduled appointments. Some the reasons would seem obvious: older people are less familiar with electronic communications, such as Zoom meetings, as was also true for those less comfortable with the English language and those who had less access to electronic devices.

One of the conclusions from the study was that more is needed to bridge racial and language gaps, by offering translational technology on the platforms used and offering technical assistance to patients. Although not readily used, even an iPhone has language translation apps. 

The pandemic has focused attention more on the pre-existing disparities in medical care by different groups. If the assumptions are correct – that the pandemic has permanently changed how medicine is practiced – then much has to be done to make medicine more accessible and adaptable to this new electronic world in which we live.