The Promise of Telemedicine: Are We Reaching the Underserved?

ABSTRACT

INTRODUCTION: The use of telemedicine has dramatically increased during the COVID-19 pandemic. We evaluated characteristics and experiences of underserved women utilizing telemedicine for gynecologic visits at an urban teaching hospital. METHODS: We conducted a prospective study of patients using telemedicine for gynecologic care from January 2021-September 2021. Patients completed a demographic survey and a modified Telemedicine Usability Questionnaire (TUQ) using a 1-5 Likert scale. Statistical analyses used Fisher's exact test. RESULTS: One hundred ninety two patients consented to participate, and 157 completed surveys. The majority of patients were non-White (Hispanic 32%, Black 28%, and Asian 10%), with a median age of 40 years (range 18-69 years). A total of 61% had children and some level of education (24% GED or below, 28% vocational/associate degree, and 47% college or above), and 41% were employed, with 63% reporting an income of less than $40,000, and 85% being government insured (Medicaid/Medicare). Without telemedicine visits, 47% would have traveled 1-2 hours to appointments, with 46% spending more than $35 on travel, and 27% missing at least 1 work day for an in-person visit. The most common visit indications were lab/imaging results review (37%), postoperative follow-up (21%), and abnormal uter- ine bleeding (14%). The mean score overall for the entire TUQ was 4.3/5. Participants preferred telemedicine for follow-up visits rather than for initial visits (81% vs. 33%;P<.01). CONCLUSION: Underserved women utilizing telemedicine for gynecologic care reported largely positive experiences with improved access to health care, cost, and time savings over inperson visits. However, a higher preference for utilization was found for follow-up visits, providing an opportunity to further improve quality and access.