Prevalence and Disparities in Telehealth Use Among US Adults Following the COVID-19 Pandemic: National Cross-Sectional Survey

A Comparison of the Convenience, Quality of Interaction, and Satisfaction of Virtual and In-Person Healthcare Consultations: A Nationwide Study

Background: There are few direct comparisons of service utilization and patient-reported outcomes in patients attending medical consultations in person or virtually. This was a prospective, cross-sectional study of adults engaging with a healthcare practitioner via virtual or in-person consultations. Methods: Participants were recruited in person by convenience sampling between November 2023 and January 2024 across Saudi Arabia, and data were gathered on (i) basic demographic and consultation information and (ii) convenience, quality of interaction, and satisfaction with their consultations. Results: Of 3196 individuals who completed the survey, 28.7% had attended their most recent healthcare interaction virtually and 71.3% had attended in person. Participants attending virtual consultations were more likely to live rurally (69.0% vs. 21.9% for in-person consultations; p < 0.001). Virtual appointments were more common for primary care and diabetes/endocrinology but not surgical specialties (p < 0.001), and private apps and hospitals more frequently provided virtual appointments. Conclusions: Overall, patients found virtual consultations to be significantly more convenient, prompt, private, and well communicated than in-person appointments, translating into extremely high satisfaction (97.4% overall vs. 84.0% for in-person consultations; p < 0.001). This study provides population-level data on the current prevalence of telehealth use in Saudi Arabia. Further prospective research demonstrating the clinical noninferiority of telemedicine could help promote further uptake in specialties such as surgery.

Predictors of telehealth use after the Minnesota Telehealth Act: analysis using the Minnesota All Payer Claims Database

During the COVID-19 pandemic, the federal government and many state governments instituted expanded coverage for telehealth (TH) services and since have maintained it. Using data from the Minnesota All Payer Claims Database and publicly available data sources, we examined TH use among commercially insured and Medicare Advantage (MA) patients in Minnesota. In 2022, 30.4% of commercially insured patients and 24.4% of MA patients used TH services. Living in a metropolitan area, an area with a high proportion of Black, Indigenous, and People of Color residents, having greater disease burden, and being younger were associated with a greater likelihood of using TH. Living in an area with limited broadband access reduced the likelihood of TH use. Two patient subgroups more likely to use TH-younger patients in metropolitan areas and high-risk patients with depression-received a similar proportion of ambulatory visits via TH.

Leveraging community Wi-Fi and spaces for digital health use

Digital health disparities continue to affect marginalized populations, especially older adults, individuals with low-income, and racial/ethnic minorities, intensifying the challenges these populations face in accessing healthcare. Bridging this digital divide is essential, as digital access and literacy are social determinants of health that can impact digital health use and access to care. This article discusses the potential of leveraging community Wi-Fi and spaces to improve digital access and digital health use, as well as the challenges and opportunities associated with this strategy. The existing limited evidence has shown the possibility of using community Wi-Fi and spaces, such as public libraries, to facilitate telehealth services. However, privacy and security issues from using public Wi-Fi and spaces remain a concern for librarians and healthcare professionals. To advance digital equity, efforts from multilevel stakeholders to improve users' digital access and literacy and offer tailored technology support in the community are required. Ultimately, leveraging community Wi-Fi and spaces offers a promising avenue to expand digital health accessibility and use, highlighting the critical role of collaborative efforts in overcoming digital health disparities.

Satisfaction with Telehealth Care in the United States: Cross-Sectional Survey

Background: Telehealth use remains high following the COVID-19 pandemic, but patient satisfaction with telehealth care is unclear. Methods: We used cross-sectional data from the Health Information National Trends Survey (HINTS 6). 2,058 English and Spanish-speaking U.S. adults (≥18 years) with a telehealth visit in the 12 months before March-November 2022 were included in this study. The primary outcomes were telehealth visit modality and satisfaction in the 12 months before HINTS 6. We evaluated sociodemographic predictors of telehealth visit modality and satisfaction via Poisson regression. Analyses were weighted according to HINTS standards. Results: We included 2,058 participants (48.4 ± 16.8 years; 57% women; 66% White), of which 70% had an audio-video and 30% an audio-only telehealth visit. Adults with an audio-video visit were more likely to have health insurance (adjusted prevalence ratio [aPR]: 1.55, 95% confidence interval [CI]: 1.18-2.04) and have an annual household income of ≥$75,000 (aPR: 1.18, 95% CI: 1.00-1.39) and less likely to be ≥65 years (aPR: 0.79, 95% CI: 0.70-0.89), adjusting for sociodemographic characteristics. No further inequities were noted by telehealth modality. Seventy-five percent of participants felt that their telehealth visits were as good as in-person care. No significant differences in telehealth satisfaction were observed across sociodemographic characteristics, telehealth modality, or the participants' primary reason for their most recent telehealth visit in adjusted analysis. Conclusions: Among U.S. adults with a telehealth visit, the majority had an audio-video visit and were satisfied with their care. Telehealth should continue, being offered following COVID-19, as it is uniformly valued by patients.