ABSTRACT
Background: Teledermatology has emerged as an essential model of care during the COVID-19 pandemic. However, the impact of the rapid transition to teledermatology on patients of certain racial/ethnic and language groups due to differential access to technology, lower digital health literacy, language barriers, or cultural perceptions is unknown. We sought to identify race and language disparities in teledermatology utilization for patients with acne, one of the most frequent diagnoses seen via teledermatology, before and during the pandemic. Methods: A retrospective chart review of all in-person and virtual visits for acne at a large academic dermatology department from March-May 2019 and March-May 2020 was conducted. Virtual visit types included video- or audio-only visits. Chi-squared analyses were performed to compare populations across visit types. Results: 3544 visits were analyzed. Virtual visits accounted for 1229/1630 (75.6%) during- pandemic visits. Racial and language distributions of patients for overall visits were not statistically significantly different pre- and during-pandemic. However, video visits (versus audio-only) comprised a greater proportion of virtual visits during-pandemic for White (86.9%) compared to non-White patients (82.0%), and for English-speaking (86.2%) compared to non-English-speaking patients (60.5%) (both p<0.001). During-pandemic, interpreters use was documented for 23.1% of all non-English-speaking patients for in-person visits versus 9.3% of virtual visits (p<0.001). Conclusions: Non-White and non-English-speaking patients were less likely to use video visits for acne during the pandemic than White and English-speaking patients. Non-English-speaking patients were less likely to receive interpreters in virtual visits than in-person visits. These findings suggest underlying disparities in teledermatology access and barriers to interpreter use during virtual visits.