Telemedicine journal and e-health : the official journal of the American Telemedicine Association最新文献

{"title":"Healthcare Professionals' Telehealth Education and Training Experiences and Needs.","authors":"Conor M C Duffy, Oswaldo Moreno, Catherine S J Wall, Ragan A DuBose-Morris, Gabrielle Cardinale-McGinnis, Dex Schult, Eric G Benotsch","doi":"10.1177/15305627261453266","DOIUrl":"10.1177/15305627261453266","url":null,"abstract":"<p><strong>Background: </strong>Medical education institutions and healthcare systems have increasingly adopted telehealth education/training since the COVID-19 pandemic. However, the duration, content, and activities included in these education/training interventions are inconsistent, and the effectiveness of existing telehealth curricula is unclear. This study investigates healthcare professionals' telehealth education/training experiences and needs.</p><p><strong>Method: </strong>A sample of 69 health care professionals who have used telehealth, including physicians, nurses, nurse practitioners, physician associates, social workers, and psychologists, completed an online questionnaire in December 2024. Questionnaire items assessed receipt, duration, content, and activities included in prior telehealth education/training, and open-ended questions further explored participants' education/training experiences and needs. Three coders analyzed qualitative data using reflexive thematic analysis.</p><p><strong>Results: </strong>Over 80% of participants reported receiving telehealth education/training during their professional careers. A higher proportion of participants reported didactic (vs. experiential) activities, and the topics explored most frequently in participants' education/training were conducting assessments/evaluations in telehealth, communication skills, and ethical considerations. Open-ended responses indicated that experiential forms of training are particularly valuable in building telehealth skills. While participants were generally confident using telehealth, troubleshooting technological difficulties was a persistent gap in existing education/training.</p><p><strong>Conclusions: </strong>Existing telehealth education/training interventions provide essential baseline knowledge and skills in telehealth delivery. However, these interventions could be enhanced by emphasizing experiential learning and providing opportunities for healthcare professionals to practice telehealth skills in realistic settings. Future research should expand upon these findings by exploring these topics among certain groups of healthcare professionals and in specific medical contexts to develop tailored telehealth education/training interventions.</p>","PeriodicalId":520784,"journal":{"name":"Telemedicine journal and e-health : the official journal of the American Telemedicine Association","volume":" ","pages":"961-969"},"PeriodicalIF":2.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148008460","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"State Policy Variation and Telehealth Use by Oncology Specialists Treating Medicaid Patients.","authors":"Anushree Vichare, Mandar Bodas, Qian Eric Luo, Nandita Khera, Arpita Gandhi, Scott A Shipman, Clese Erikson","doi":"10.1177/15305627261455444","DOIUrl":"10.1177/15305627261455444","url":null,"abstract":"<p><p>Telehealth may improve access to specialized oncology care for Medicaid beneficiaries with hematological malignancies who face geographic and financial barriers. During the COVID-19 public health emergency, telehealth use expanded rapidly, yet state policies governing telehealth coverage/payment parity varied. Evidence is limited on how these policy differences influenced oncology telehealth use for Medicaid patients. We conducted a cross-sectional analysis of 2020-2021 multistate Medicaid claims. Adult and pediatric oncology specialists were identified based on board certification data. Telehealth video visits were measured monthly at the extensive margin, defined as the proportion of specialists providing any telehealth, and the intensive margin, defined as average monthly telehealth visits among telehealth providing specialists. States were categorized by private insurance telehealth policy environment: coverage and payment parity, coverage parity only, or no or unspecified parity. Telehealth use increased sharply across all states in early 2020, rising from less than 1% of specialists before the pandemic to peak levels by April 2020. Specialists practicing in coverage and payment parity states demonstrated higher and more sustained telehealth use through 2021 compared with those in coverage only or no parity states. By December 2021, 15.1% of adult specialists in coverage and payment parity states provided telehealth, compared with 8.1% in coverage-only states and 7.8% in no-parity states. Pediatric specialists showed similar patterns, though overall telehealth use remained lower. Specialists in parity states also maintained higher monthly telehealth visit volumes over time. State-level coverage and payment parity policies may have been associated with greater and sustained telehealth provision by oncology specialists treating Medicaid beneficiaries with hematologic malignancies. Maintaining supportive telehealth policies may be essential for promoting equitable access to specialized cancer care and reducing disparities among underserved populations. These findings inform future telehealth policy decisions nationally statewide.</p>","PeriodicalId":520784,"journal":{"name":"Telemedicine journal and e-health : the official journal of the American Telemedicine Association","volume":" ","pages":"970-974"},"PeriodicalIF":2.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148045405","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Telehealth Use and Nonuse Among Cancer Survivors in the United States and Associations with Adverse Social Determinants of Health.","authors":"Kassandra I Alcaraz, Camryn M Cohen, Avonne E Connor","doi":"10.1177/15305627261450362","DOIUrl":"10.1177/15305627261450362","url":null,"abstract":"<p><strong>Background: </strong>Adverse social determinants of health (SDOH) influence healthcare utilization in cancer survivorship, yet limited research has examined associations of SDOH with telehealth use among cancer survivors. This study examined telehealth use and associations with adverse SDOH in a nationally representative sample of cancer survivors.</p><p><strong>Methods: </strong>The study utilized cross-sectional data from adult cancer survivors who responded to the National Cancer Institute's Health Information National Trends Survey (HINTS) in 2022 (HINTS 6) and 2024 (HINTS 7). Bivariate analyses and multivariable logistic regression were used to examine associations between experiencing adverse SDOH and telehealth use, based on variables for each individual adverse SDOH and a composite variable reflecting the total number of adverse SDOH. Unweighted frequencies and weighted percentages are reported.</p><p><strong>Results: </strong>Of the 1,912 cancer survivors, representing more than 11 million survivors, 42.8% used telehealth. Younger age, being obese, and having ≥3 comorbidities were associated with greater telehealth use. For all SDOH measures, experiencing adverse SDOH was positively associated with telehealth use in bivariate analyses. In multivariable analyses, survivors experiencing one adverse SDOH had twice the odds of using telehealth as survivors not experiencing adverse SDOH (odds ratio 2.03, 95% confidence interval 1.08-3.80). However, experiencing more than one adverse SDOH was not associated with telehealth use. Several reasons for telehealth use and nonuse varied by adverse SDOH.</p><p><strong>Conclusions: </strong>Findings suggest that telehealth is an accessible tool among some survivors experiencing adverse SDOH. However, targeted strategies may be needed for survivors experiencing multiple SDOH.</p>","PeriodicalId":520784,"journal":{"name":"Telemedicine journal and e-health : the official journal of the American Telemedicine Association","volume":" ","pages":"912-922"},"PeriodicalIF":2.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147937347","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effectiveness of Telemedicine-Based Interventions in Primary Health Care: A Systematic Review in a Universal Health System.","authors":"Gustavo Maciel Oliveira, Maria Carolinne Feitosa de Lyra Amorim Ferreira, Samuel Soares Filho, Odilon Mangerona Netto, Jamil Ribeiro Cade","doi":"10.1177/15305627261453270","DOIUrl":"10.1177/15305627261453270","url":null,"abstract":"<p><strong>Introduction: </strong>Telemedicine has increasingly been adopted as a digital care strategy to support access, continuity, and care coordination in primary health care (PHC). While its use accelerated during the COVID-19 pandemic, evidence regarding the effectiveness of telemedicine-based interventions in routine primary care remains heterogeneous and highly context-dependent. The objective of this review was to critically assess the effectiveness of telemedicine-based interventions in PHC, focusing on their effects on access, continuity, and care coordination, and to identify implementation-related barriers and facilitators based on empirical evidence from a universal health system context.</p><p><strong>Methods: </strong>A systematic review was conducted in accordance with PRISMA 2020 and registered in PROSPERO (CRD420251005446). Searches were performed in PubMed/MEDLINE, SciELO, and BVS/LILACS for studies published between 2015 and 2025. Two reviewers independently screened studies and extracted data. Risk of bias was assessed using RoB 2.0 and ROBINS-I. Due to methodological heterogeneity, findings were synthesized through a structured narrative approach (SWiM), and certainty of evidence was interpreted qualitatively based on study design, risk of bias, and consistency of findings.</p><p><strong>Results: </strong>Twenty-two studies were included, evaluating teleconsultations, telemonitoring, telediagnosis, tele-regulation, and tele-education in PHC settings. Telemedicine-based interventions were associated with improved access, reduced waiting times, and enhanced care coordination, particularly when embedded within primary care teams and integrated with information systems. Telemonitoring showed more consistent benefits for chronic disease management and continuity of care. User and provider acceptability was generally high, although technical limitations, workload concerns, and digital inequities were frequently reported. Certainty of evidence ranged from low to moderate.</p><p><strong>Conclusions: </strong>Telemedicine-based interventions can strengthen core PHC functions when implemented as integrated organizational components of routine care delivery rather than as standalone technologies. Their effectiveness is strongly shaped by implementation context, digital infrastructure, and workforce readiness, highlighting the need for pragmatic and implementation-focused evaluations to inform sustainable telemedicine integration in primary care systems.</p>","PeriodicalId":520784,"journal":{"name":"Telemedicine journal and e-health : the official journal of the American Telemedicine Association","volume":" ","pages":"887-894"},"PeriodicalIF":2.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148045454","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Matching Primary Care and Integrated Mental Health Visits by Care Modality and Linkage to Same-Day Services for Veterans.","authors":"Amy G Bonilla, Darren Lov, Taona P Haderlein, Nicholas J Jackson, Lucinda B Leung","doi":"10.1177/15305627261479261","DOIUrl":"10.1177/15305627261479261","url":null,"abstract":"<p><strong>Purpose: </strong>The Veterans Health Administration (VHA) aims to provide same-day access from Primary Care to Integrated Mental Health (PCMHI) teams but faces challenges coordinating virtual services across traditional clinic workflows. This study examined whether modality concordance for primary care and PCMHI visits (i.e., both video, both phone, or both in-person) is associated with higher probability of receiving same-day PCMHI care.</p><p><strong>Methods: </strong>This retrospective cohort study included 952,749 VHA primary care patients who newly initiated PCMHI services between FY2019 and FY2023 (October 1, 2018 and September 30, 2023). Same-day care was defined as receiving PCMHI services on the same day as a primary care visit. The exposure was the modality combination used for primary care visits and their resulting PCMHI visits. Multilevel regression models controlled for patient characteristics, clinic-level factors, year, VHA regional network, and clinic clustering.</p><p><strong>Major findings: </strong>The highest probability for same-day PCMHI care was when both visits were conducted in-person (59%, <i>p</i> < 0.001). This probability dropped to 35% and below for all cases where phone or video was utilized for either visit. Further analysis demonstrated that modality concordance contributed minimally to same-day care after calculating the variance contributed by any telehealth (phone/video) use.</p><p><strong>Conclusions: </strong>The use of phone or video visits appeared to hinder the ability to provide same-day patient handoffs from primary care to PCMHI, even when the same modality was used for both visits. Interdisciplinary team workflows need to overcome barriers associated with telehealth (phone/video) use in general, which may not be easily rectified by matching on visit modality.</p>","PeriodicalId":520784,"journal":{"name":"Telemedicine journal and e-health : the official journal of the American Telemedicine Association","volume":" ","pages":"15305627261479261"},"PeriodicalIF":2.0,"publicationDate":"2026-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148805465","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Statewide Clinic-to-Clinic Pediatric Subspecialty Telemedicine Model: Implementation, Scale, and Stakeholder Experience.","authors":"Abigail Crawford, Margaret Jaynes, Audra Rouster, Rafka Chaiban, Andrea L Martin, David Thomas, Federico G Seifarth, Charles J Mullett","doi":"10.1177/15305627261478450","DOIUrl":"https://doi.org/10.1177/15305627261478450","url":null,"abstract":"<p><strong>Objective: </strong>To describe the implementation, scale, and stakeholder experience of a statewide clinic-to-clinic pediatric subspecialty telemedicine program improving access to care for children in rural and underserved communities.</p><p><strong>Methods: </strong>A hub-and-spoke telemedicine network was developed linking pediatric subspecialists at an academic children's hospital with advanced practice providers (APPs) at five regional spoke clinics. In this hybrid clinic-to-clinic model, APPs performed in-person assessments and facilitated synchronous telemedicine consultations for all new patients. Program utilization, travel burden reduction, and parent survey responses were analyzed descriptively; free-text parent comments and a provider panel discussion underwent qualitative content analysis.</p><p><strong>Results: </strong>From 2018 through 2024, the program completed 21,838 visits across 21 pediatric subspecialties, involving 98 clinicians. Families avoided an estimated 5.9 million travel miles, 99,000 travel hours, and approximately 2,400 metric tons of CO₂ emissions. Among 251 surveys returned, 90.0% of the 239 parents answering the rating item rated care as excellent and 8.8% as good. Providers attributed the model's success to deliberate program infrastructure and standardization, strong trust and communication between subspecialists and site APPs, and improved access to timely subspecialty care closer to home. Full-time spoke sites achieved operational sustainability, whereas part-time sites were limited by staffing and workflow barriers.</p><p><strong>Conclusions: </strong>A clinic-to-clinic telemedicine model incorporating trained APPs at the point of care can sustainably expand pediatric subspecialty access while reducing travel burden and supporting provider satisfaction and retention. This scalable hybrid framework may help health systems address geographic barriers and pediatric subspecialty shortages.</p>","PeriodicalId":520784,"journal":{"name":"Telemedicine journal and e-health : the official journal of the American Telemedicine Association","volume":" ","pages":"15305627261478450"},"PeriodicalIF":2.0,"publicationDate":"2026-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148764560","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Teleretinal Imaging Enhances Equity in Diabetic Eye Screening at Urban Community Health Clinics.","authors":"Jacob Khoussine, Kyle Peterson, Christiana Fowlkes, Cinthya Maldonado, Johnson Hoang, Thomas Emmet, Maria Mora Pinzon, Diana Garcia, Yohualli Anaya, Roomasa Channa, Yao Liu","doi":"10.1177/15305627261477819","DOIUrl":"10.1177/15305627261477819","url":null,"abstract":"<p><strong>Background: </strong>We evaluated the impact of a teleretinal screening program on increasing diabetic eye screening within urban community health clinics and factors associated with screening receipt.</p><p><strong>Materials and methods: </strong>A clinical teleophthalmology program providing teleretinal imaging for diabetic eye screening was introduced at two clinics (Clinics A and B) in an urban federally qualified health center in Madison, Wisconsin. We conducted a retrospective, cross-sectional study during the baseline (2020-2022) and teleophthalmology (2022-2024) periods and used logistic regression to identify factors associated with screening receipt.</p><p><strong>Results: </strong>During the baseline period, patients (<i>n</i> = 1,094) had a mean age of 54 years, with 24.0% self-identifying as Black/African American and 44.8% as Hispanic/Latino, and 30.0% were uninsured. Screening increased from 14.4% to 40.3% (<i>p</i> < 0.001) in the teleophthalmology period, with the largest increases observed among Hispanic/Latinos (+32.1%) and the uninsured (+33.6%). In the multivariable analysis, men and uninsured patients became equally likely to receive screening in the teleophthalmology period as women and Medicare patients, respectively. However, those with Medicaid or commercial insurance remained less likely to obtain screening (OR: 0.63-0.69, 95% CI: 0.44-0.99) than those with Medicare. Those obtaining care at Clinic B were less likely to obtain screening than those at Clinic A in the baseline period but were more likely to obtain screening in the teleophthalmology period (OR: 1.75, 95% CI: 1.37-2.23).</p><p><strong>Conclusions: </strong>Teleophthalmology increased diabetic eye screening equity based on sex and insurance status. Clinic-level strategies to enhance patient outreach, clinical staff engagement, and clinic resource allocation may allow for further advances in telemedicine screening equity.</p>","PeriodicalId":520784,"journal":{"name":"Telemedicine journal and e-health : the official journal of the American Telemedicine Association","volume":" ","pages":"15305627261477819"},"PeriodicalIF":2.0,"publicationDate":"2026-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148766560","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessment Tools for Student Telehealth Competency: A Scoping Review.","authors":"Kate Bridgman, Shane Erickson, Tim Burke, Annie Hill, Carol McKinstry","doi":"10.1177/15305627261473406","DOIUrl":"https://doi.org/10.1177/15305627261473406","url":null,"abstract":"<p><strong>Introduction: </strong>Telehealth is widely used by health professionals and students to deliver services in various settings. Health students need to acquire telehealth competencies prior to and during placement for safe delivery and competent practice. Therefore, understanding which student telehealth competencies have been assessed following a learning activity and what measures are used to do so in the literature is needed.</p><p><strong>Methods: </strong>A scoping review was undertaken to identify (1) existing tools that measure telehealth competencies in students undertaking synchronous telehealth learning activities and (2) the telehealth competencies that these tools measure. Relevant electronic databases were searched. Titles and abstracts were independently reviewed by two researchers and included if published between 1995 and 2025, involved synchronous telehealth activities with real or simulated patients, and student telehealth competencies were assessed. Data were extracted and analyzed.</p><p><strong>Results: </strong>Fifty-seven studies met inclusion criteria, with 82% conducted in the United States. Forty-nine studies (86%) used a case series research design. Students were from 10 health disciplines. Most studies (91%) used video-based telehealth activities. Almost three quarters of studies included simulation activities to facilitate telehealth learning. Outcome measures to evaluate student telehealth competencies were largely developed for individual studies, and most did not have established psychometric properties. Telehealth competencies assessed were in three areas: professional competencies, clinical competencies, and telehealth-specific competencies.</p><p><strong>Conclusion: </strong>Simulation is a commonly utilized learning activity to develop student telehealth competencies. There is a lack of specifically designed tools to assess student telehealth competencies. Further research is needed to develop robust assessment tools with established psychometric properties.</p>","PeriodicalId":520784,"journal":{"name":"Telemedicine journal and e-health : the official journal of the American Telemedicine Association","volume":" ","pages":"15305627261473406"},"PeriodicalIF":2.0,"publicationDate":"2026-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148709349","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessing Mobile Health Readiness among Patients at a Southern Indian Eye Hospital: Access, Proficiency, and Attitudes Toward mHealth Tools.","authors":"Sage Leland, Selvaraj Jerrome, G Murugaraj, Ramalakshmi Raman, Dhivya Ramasamy","doi":"10.1177/15305627261475887","DOIUrl":"https://doi.org/10.1177/15305627261475887","url":null,"abstract":"<p><strong>Background: </strong>Mobile health (mHealth) technologies have the potential to transform health care delivery in low- and middle-income countries, particularly in ophthalmology. However, effective implementation depends on patients' readiness, access to mobile devices, and ability to use them. This study aimed to assess patients' readiness for mHealth by examining mobile phone ownership patterns, evaluating proficiency in phone use, and exploring attitudes toward adopting mHealth tools.</p><p><strong>Methods: </strong>A cross-sectional questionnaire-based survey was conducted across three care settings at a tertiary eye hospital: the free section, paying section, and vision centers (VCs). Patients were randomly selected from clinic populations to reduce interviewer bias. Prior focus group discussions informed questionnaire refinement to capture diverse digital usage patterns. Sampling was structured according to average patient volume in each clinic. Data were collected from August to October 2023.</p><p><strong>Results: </strong>Totally, 946 patients were interviewed: 41% were feature phone owners (FPOs), 37% smartphone owners (SPOs), and 21% had no phone (NPOs). Smartphone ownership was highest in the paying section (53%), feature phone ownership in the subsidized section (45%), and no-phone ownership in VCs (45%). Among NPOs, 80% were women. Patients aged over 60 were significantly less likely to own smartphones than feature phones (odds ratio [OR] = 0.10, <i>p</i> < 0.001) or have no phone (OR = 0.18, <i>p</i> < 0.001). Higher literacy levels were strongly associated with smartphone ownership. Nearly all SPOs and FPOs could receive calls, but far fewer FPOs could read (15-33%) or send short message service (2-8%). Only 22% of SPOs sought health information online, while most FPOs and NPOs did not use the internet. Electronic consent was acceptable to most SPOs and FPOs, but not among NPOs.</p><p><strong>Conclusions: </strong>Significant disparities in mobile phone ownership, digital proficiency, and attitudes toward mHealth exist among patients. mHealth interventions must therefore align with patient capabilities to ensure equitable and effective implementation.</p>","PeriodicalId":520784,"journal":{"name":"Telemedicine journal and e-health : the official journal of the American Telemedicine Association","volume":" ","pages":"15305627261475887"},"PeriodicalIF":2.0,"publicationDate":"2026-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148709288","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Telehealth Versus In-Person Care: A Systematic Review of Appointment Attendance and Engagement in Vulnerable Communities.","authors":"Madison Sigler, Elly Georgas, Hyrum Brodniak","doi":"10.1177/15305627261477817","DOIUrl":"https://doi.org/10.1177/15305627261477817","url":null,"abstract":"<p><strong>Background: </strong>Underserved populations experience structural barriers to health care access, including transportation limitations and socioeconomic constraints, which contribute to high no-show rates. Telehealth may mitigate these barriers; however, its impact on objective health care utilization metrics requires systematic evaluation. The objective of this article is to compare visit completion and no-show rates between telehealth and in-person care among underserved populations.</p><p><strong>Methods: </strong>A systematic search of PubMed (January 2016-January 2026) was conducted following Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020 guidelines. We included peer-reviewed studies focusing on rural, low-income, Medicaid-insured, and racial/ethnic minority populations that reported objective attendance data. This systematic review was prospectively registered in PROSPERO on February 18, 2026 (Registration No. CRD420261320752).</p><p><strong>Results: </strong>Seventeen studies encompassing over 2.5 million encounters were included. Telehealth was consistently associated with reduced no-show rates across diverse settings. In a large safety-net system, no-show rates decreased from 25.1% to 14.6%. In primary care, telehealth narrowed the completion gap between Black and non-Black patients by 11.7 percentage points. Specialty applications, including postpartum monitoring and HIV care, demonstrated higher visit completion rates with telehealth.</p><p><strong>Conclusions: </strong>Telehealth is associated with improved appointment adherence and reduced disparities in health care access among underserved populations. Sustaining these benefits will require continued policy support, including reimbursement for audio-only modalities.</p>","PeriodicalId":520784,"journal":{"name":"Telemedicine journal and e-health : the official journal of the American Telemedicine Association","volume":" ","pages":"15305627261477817"},"PeriodicalIF":2.0,"publicationDate":"2026-08-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148702923","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}