COVID-19 pandemic has triggered the widespread adoption of Telemedicine (TM). As physical distancing measures were established, we rapidly shifted our outpatient appointments to TM. Here we show findings regarding patient TM perception and attendance. Patient demographics and attendance to in person and TM outpatient encounters from January to July 2020 were reviewed. A survey evaluating TM perceptions was distributed to patients and their families following an encounter between March and July 2020. Our diabetes clinic currently cares for 1504 unique patients with type 1 diabetes (T1D) with 46% being publicly insured. A total of 1,653 encounters including in person and TM were included in the analysis. TM visits became available in March 2020, with a total of 571 encounters by July 2020. There was a significantly lower number of completed TM encounters by publicly insured patients when compared with privately insured (p value=0.03523) and a threefold increase in no-shows and same day cancelations by the publicly insured group. Perception of TM was addressed with a survey completed by 40 patients. TM perception was positive with 86% of patients being very satisfied with the visit. TM encounter was thought to be the same as in person encounter by 60% and better than in person visit by 37% of patients. Reported benefits associated with TM included: overall time saved, no missed school day for the patient or workday for the parent, decreased childcare and transportation costs.
In conclusion, although TM is perceived as positive by patients with T1D, low-income families showed lower TM visit attendance rate when compared to privately insured families. The COVID-19 pandemic has highlighted disparities related to access to and use of technology to improve diabetes care. More research is needed to identify the specific causes for the disparities. Patient centered approach to increase education and help navigate the processes required for utilizing TM technology may help decrease the health equity gaps.
C. Demeterco-berggren: None. M. Gottschalk: None.