The role of increasing synchronous telehealth use during the COVID-19 pandemic on disparities in access to healthcare: A systematic review

Sara Ternes; Lauren Lavin; J Priyanka Vakkalanka; Heather S Healy; Kimberly As Merchant; Marcia M Ward; Nicholas M Mohr

doi:10.1177/1357633X241245459

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The role of increasing synchronous telehealth use during the COVID-19 pandemic on disparities in access to healthcare: A systematic review

Journal article

Peer reviewed

The role of increasing synchronous telehealth use during the COVID-19 pandemic on disparities in access to healthcare: A systematic review

Sara Ternes, Lauren Lavin, J Priyanka Vakkalanka, Heather S Healy, Kimberly As Merchant, Marcia M Ward and Nicholas M Mohr

Journal of telemedicine and telecare, Vol.31(8), pp.1091-1113

09/2025

DOI: 10.1177/1357633X241245459

PMID: 38646804

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Abstract

The COVID-19 public health emergency led to an unprecedented rapid increase in telehealth use, but the role of telehealth in reducing disparities in access to care has been questioned. The objective of this study was to conduct a systematic review to summarize the available evidence on how telehealth during the COVID-19 pandemic was associated with telehealth utilization for minority groups and its role in health disparities. We conducted a systematic review focused on health equity and access to care by searching for interventional and observational studies using the following four search domains: telehealth, COVID-19, health equity, and access to care. We searched PubMed, Embase, Cochrane CENTRAL, CINAHL, telehealth.hhs.gov, and the Rural Health Research Gateway, and included any study that reported quantitative results with a control group. Our initial search yielded 1970 studies, and we included 48 in our final review. The most common dimensions of health equity studied were race/ethnicity, rurality, insurance status, language, and socioeconomic status, and the telehealth applications studied were diverse. Included studies had a moderate risk of bias. In aggregate, most studies reported increased telehealth use during the pandemic, with the greatest increase in non-minority populations, including White, younger, English-speaking people from urban areas. We found that despite rapid adoption and increased telehealth use during the public health emergency, telehealth did not reduce existing disparities in access to care. We recommend that future work measuring the impact of telehealth focus on equity so that features of telehealth innovation can reduce disparities in health outcomes.

Telemedicine

COVID-19

rural population

ethnicity

accessibility

healthcare disparities

systematic review

equity

Details

Title: Subtitle: The role of increasing synchronous telehealth use during the COVID-19 pandemic on disparities in access to healthcare: A systematic review
Creators: Sara Ternes - University of Iowa
Lauren Lavin - University of Iowa
J Priyanka Vakkalanka - University of Iowa
Heather S Healy - University of Iowa
Kimberly As Merchant - Department of Health Management and Policy, University of Iowa College of Public Health, Iowa City, IA, USA
Marcia M Ward - University of Iowa
Nicholas M Mohr - Department of Anesthesia Critical Care, University of Iowa Carver College of Medicine, Iowa City, IA, USA
Resource Type: Journal article
Publication Details: Journal of telemedicine and telecare, Vol.31(8), pp.1091-1113
DOI: 10.1177/1357633X241245459
PMID: 38646804
NLM abbreviation: J Telemed Telecare
eISSN: 1758-1109
Language: English
Electronic publication date: 04/22/2024
Date published: 09/2025
Academic Unit: Rural Telehealth Research Center; Health Management and Policy; Epidemiology; Emergency Medicine; Anesthesia; Injury Prevention Research Center; Hardin Library
Record Identifier: 9984618503502771

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