The effects of COVID-19 on access to telemedicine visits in a tertiary headache clinic

ABSTRACT

Objective: Determine the effect of COVID-19 on telemedicine access for racial minorities prior to, during and following the COVID-19 surge at the Cleveland Clinic Headache Section. Background: Racial, ethnic and socioeconomic minority patients face significant barriers to receiving equal access to health care. Telemedicine has the potential to increase access to specialty medical care among the urban underserved. We seek to understand the effects of rapid implementation of telehealth across different racial subgroups during the COVID-19 pandemic. Design/Methods: We conducted a retrospective data review of patient visits at Cleveland Clinic Headache Section during the following time points January 1 - March 13, 2020 (control - prior to COVID-19 pandemic surge), March 16, 2020 - May 22, 2020 (COVID-19 surge) and May 26, 2020 - August 20, 2020 (post COVID-19 surge) in 2020. We compared demographic data (age, sex, race, and marital status). Results: Pre COVID-19 pandemic surge included 380 virtual visits of which, 339 (89%) were white and 18 (4.7%) were identified as BIPOC (black, indigenous people of color). In-person visit group included 1890 patients with 1426 white (75%) and 365 (19%) identified as BIPOC. During the COVID surge, there were 1797 virtual visits with 1423 (79% white) and 303 (17%) BIPOC. The post COVID-19 surge had 1801 virtual patients with 1472 (82% white) and 256 (14%) BIPOC. In person group had 805 patients with 582 white (72%) white and 187 (23%) BIPOC. Conclusions: Pre-COVID-19 pandemic there was proportionally less usage of virtual visits by minorities compared to whites. It was unclear if such groups would have the same access to virtual care. However, during COVID-19 surge we saw a slight increase in virtual visits by minority groups which continued post COVID-19 surge when in person visits began. We also saw an overall slight increase in healthcare utilization by this minority group.