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Penn study shows telemedicine offers a barrier for those who don’t speak English

She had tried to call a city health clinic to get asthma medicine for the teenage girl, but was directed to set up a medical appointment through video chat — a big hurdle, as the family lived in a shelter and had no high-speed internet. What’s more, the instructions were in English, and the woman, an immigrant from Guatemala, did not speak the language well.

As with so many other aspects of life during the pandemic, the field of health care has shifted the bulk of its interactions to computer screens and mobile phones — the practice known as telemedicine. It can be an effective substitute for an in-person visit, except when patients lack the necessary technology or have trouble using it.

In a group of 2,940 patients scheduled for outpatient cardiology visits between March 16 and April 17, those who spoke limited or no English were half as likely as English-speaking patients to “show up” for their video or phone consultation.

Income also appeared to play a role in access to care. People from zip codes with a median household income below $50,000 were half as likely to use video to see the doctor when compared with zip codes with a median income above $100,000. Instead, they opted for a consultation by phone call, said Penn cardiology fellow Lauren A. Eberly, one of the study’s authors.

Medical appointments via phone call are far better than none at all. But the addition of video may allow physicians and nurses to gain more insight into a patient’s condition, Eberly said. They can see patients’ pill bottles, for example, ensuring that they have an adequate supply and are not taking medicines that might interfere with each other.

The clinic already provided translation services during video consultations, but arranging them was a cumbersome, multi-step process that had to be set up in advance, said cardiologist Srinath Adusumalli, the study’s senior author. The center’s tech wizards are developing a new platform that will allow patients to select the appropriate language on the spot, he said.

As for those with limited internet access, Penn has applied for funds to help patients obtain broadband coverage, and also is exploring the possibility of installing telemedicine kiosks. These units could be installed at a grocery store or a recreation center, with a curtain or door for privacy, Adusumalli said.

This content was originally published here.

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