Access to Telemedicine Varies for Head and Neck Cancer Patients

Dentistry Today


The use of telemedicine has been exceptionally effective in meeting the healthcare needs of patients throughout the COVID-19 pandemic, according to the Henry Ford Health System, but socioeconomic factors may affect how head and neck cancer patients are using technology to access care.

For example, the researchers said, head and neck cancer patients who were low-income, on Medicaid, or uninsured were more likely to complete a virtual visit by telephone rather than by video. Also, women with a lower median household income were less likely to complete a telemedicine visit than men in the same income bracket.

Further study is needed to explain patients’ reticence with completing video visits, which provide a more comprehensive healthcare assessments than phone calls with their doctor, the researchers said.

“While virtual care may provide a promising platform for expanded access to care in some patients, it must be implemented in a way that it doesn’t create barriers to already disadvantaged patient populations,” said Samantha Tam, MD, a study coauthor and otolaryngologist with Henry Ford’s Department of Otolaryngology—Head and Neck Surgery.

The pandemic-driven need to access care via telemedicine prompted the researchers to evaluate whether socioeconomic factors impacted a patient’s ability to receive virtual care. The researchers analyzed census-based socioeconomic data of head and neck cancer patients who had a telemedicine visit between March 17 and April 24, 2020, and compared the results to a similar cohort from the same timeframe in 2019.

Data included patients’ age, sex, race, insurance status, household income, education, martial and employment status, and English-speaking households. Patient visits were categorized by virtual visits using live audio and video, visits completed by telephone only, in-person visits, and no-show or canceled visits.

Data from 401 patient encounters during the 2020 study period was collected. From those numbers, 246 encounters (86.3%) were completed by 234 patients. In-person visits consisted of 87 patients (25.1%), 170 (49.1%) were virtual visits, and 89 (23.6%) were telephone visits. In comparison, 551 of 582 visits (94.7%) in 2019 were completed by 394 patients, with no telemedicine visits completed that year.

“We know that access to smartphones and video technology is not a universal but almost everyone has access to a telephone,” said Vivian Wu, MD, a study coauthor and otolaryngologist. “As virtual care expands during and after this pandemic, we must keep in mind that a phone call remains an important communication method for patients to talk to their doctor.”

Since the retrospective study was observation-based, the researchers said that they did not evaluate whether patients had access to mobile “smart” phones and internet connectivity.

The study, “Disparities in the Uptake of Telemedicine During the COVID-19 Surge in a Multidisciplinary Head and Neck Cancer Population by Patient Demographic Characteristics and Socioeconomic Status,” was published by JAMA Otolaryngology-Head & Neck Surgery.

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