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School of Medicine Columbia

School of Medicine researcher focuses on access to telehealth

University of South Carolina School of Medicine Columbia Assistant Professor of Internal Medicine Christopher W. Goodman, M.D., has co-authored a study focusing on the accessibility of virtual visits or telehealth for urgent care among U.S. hospitals. The COVID-19 crisis has demonstrated an opportunity to continue and grow the use of telemedicine once the crisis subsides.

The study has brought to light disparities in access to such care, including language barriers, exclusions for certain health conditions, visibility of access to care through hospital websites and required upfront payment with no options for those with inability to pay.

Goodman, who is a 2010 graduate of the UofSC School of Medicine  works with Palmetto Health-USC Internal Medicine, part of Prisma Health-Midlands. He also serves as co-medical director for the Good Samaritan Clinic, a nonprofit organization that provides no-cost medical care to underserved communities with locations throughout South Carolina.

Goodman became curious about what other health care organizations were providing in terms of virtual urgent care platforms when Prisma Health launched its virtual care site. He wondered how some of the patients he sees at the community clinic might access those sites.

“When we first became aware of the COVID-19 crisis and the value of doing more virtual care, I began to look at the site through the lens of patients,” he says. “Recognizing that it was not an easy access point for someone with limited English proficiency made me begin to wonder what other hospitals were doing.”

Goodman’s team assembled a sample of 170 hospitals across the nation based on gross revenue, geographic diversity and bed size, with at least one hospital included from each state. The survey, focused on availability of virtual visits, language accommodations and affordability. Goodman noted that while language is an obvious obstacle, other issues such as cost came to light as a result of the survey.

“It became apparent that cost was a significant barrier,” he says, “because cost for a virtual visit is almost always an upfront cost with no allowances or considerations for the underprivileged or ability to pay.”

Other issues brought to light include lack of availability of virtual visits for those who are hearing or vision impaired. Goodman believes the survey has brought to light that virtual care is augmenting existing health care inequities.

“If you can speak English, have good internet access and can afford it, then you’re OK,” he says. “Regulatory structures that exist in clinical settings should be applied in the virtual world. There needs to be more of a national conversation.”

Goodman also say that, as COVID-19 consumes hospital resources, the need for virtual care will continue to grow, adding that “hospitals have to focus on making access as equitable as possible.”

Read the full results of the survey.

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