Uncovering Disparities in Teleneurology Utilization Post-Pandemic

Announcer:
Welcome to On the Frontlines of Multiple Sclerosis on ReachMD. On this episode, we’ll learn about disparities in telemedicine utilization for neurologic care with Dr. Marisa McGinley. Dr. McGinley is a neurologist at the Cleveland Clinic who specializes in multiple sclerosis care. She was also the lead author of a recent study focusing on this exact topic. Let’s hear from Dr. McGinley now.

Dr. McGinley:
So our team really wanted to look at disparities in teleneurology care for a couple of reasons. Obviously with the pandemic, there was a huge increase in utilization of teleneurology and so it was exciting to see that this modality was being used more. But with any kind of new healthcare delivery method, there’s always concerns that it could result in either the widening of certain disparities or new disparities emerging. And then on the flipside, we also wanted to understand if it was helping with any known healthcare disparities. And so it was just a really new area for us of teleneurology in such a wide array of conditions, but we felt like it was important.

And then a lot of the data out there described that initial boom in the utilization of teleneurology, which is exciting, but also, as we moved further away from the initial pandemic, the other thing that we really wanted to do was understand the continued utilization of teleneurology and how those use patterns changed over time as we got out of those first couple of months, where there were the stay-at-home orders and a lot more mandates to use the technology. 

Overall, there was that initial increase in utilization of teleneurology by all groups of individuals. We also found that the further we moved away from the pandemic, utilization also decreased for everyone, but it decreased more significantly for certain populations. And so what we found in this, what we called a later-pandemic epoch, was that after those initial three months of the pandemic, teleneurology was utilized at a lower degree by older individuals, Black individuals, and Hispanic individuals, as well as those higher on the Area Deprivation Index, those with nonprivate insurance such as Medicaid and Medicare, and those that preferred a language other than English as a primary language. So again, what we saw was there were disparities in utilization in those populations.

What we did see was that there was a higher use by female individuals and those that lived a greater distance from the Cleveland area, where Cleveland Clinic is located. And then we also saw that people that were out of state utilized it more. And then one other important finding was that we didn’t see any difference in utilization between our urban and rural patients.

So overall, these findings reiterated some of our concerns about groups of individuals that have known health disparities for other types of healthcare delivery and access issues. We saw that they also utilized teleneurology less. I think the promising findings that we saw there was that those that lived further away and those in rural communities are utilizing teleneurology at a greater degree or a similar degree to our urban populations. This was reassuring in that this modality may actually be improving access to care for those certain populations. So, again, I think we saw a huge increase in use, which is fantastic. More people are able to utilize that compared to pre-pandemic. But I think there are important disparities that were emerging later on that we need to be cognizant of. 

Announcer:
That was Dr. Marisa McGinley talking about current disparities in telemedicine use for neurologic care. To access this and other episodes in our series, visit On the Frontline of Multiple Sclerosis on ReachMD.com, where you can Be Part of the Knowledge. Thanks for listening!