EN-728-03 A WIDENING DIGITAL DIVIDE: UTILIZATION OF VIRTUAL VISITS IS REDUCED OVER TIME FOR BLACK AND HISPANIC COMMUNITIES

ABSTRACT

Background: Social distancing restrictions resulted in increased utilization of virtual visits (VVs) for arrhythmia care in 2020. Over time, there has been a return to in-person visits (IPVs);however, utilization of VVs may continue to offer advantages for patients. Objective: To assess characteristics of patients durably adopting virtual care. Methods: All appointments in our arrhythmia clinics from March 2020 through November 2021 were analyzed. Completed appointments by EP providers were categorized as VV or IPV. The VV rate was calculated as number of VVs divided by total Visits (IPVs and VVs). Pt characteristics collected included self-identified race and ethnicity as well as age, gender, and insurance status. We compared VV rates amongst patients of different ethnicity, race, and insurance status. We also assessed enrollment in an internet-based patient portal that interfaces with the electronic medical record (EMR) and allows for communication with providers. Results: A total of 6,084 VVs and 10,942 IPVs were included in the analysis. In 2020, 3,550 VVs comprised the majority (52.8% of 6,723) of all outpatient visits, whereas in 2021, this proportion dropped to 24.6% (2,534/10,303) as IPVs became more common. The largest reduction in VV utilization was amongst Black patients (65.2% reduction to a 19% VV rate) followed by Hispanics (62.3% reduction to a 15.8% VV rate). Both groups had a significantly reduced VV utilization rate compared to others in 2021 (P<0.01). There was no significant difference in VV rates for underinsured patients in 2020 or 2021, indicating social but not economic influence on telehealth adoption. Enrollment in the EMR patient portal during the study period was significantly reduced for Black and Hispanic patients (67.4% and 63.1% vs 80.6%;P<0.01) but did not significantly change over time. Conclusion: There was a large reduction in the overall use of VVs for arrhythmia care from 2020 to 2021. The largest reductions in VV utilization were observed in the Black and Hispanic communities, where digital health resources appeared to be underutilized. [Formula presented]