1. What is the decision or change (e.g., clinical topic, practice guideline, system design, delivery of care) you are facing or struggling with where a summary of the evidence would be helpful?
Color of Crohn’s and Chronic Illness (COCCI) is a national patient advocacy organization whose mission is to improve the quality of life for BIPOC who are affected by IBD, Digestive Disorders and associated Chronic Illnesses; it is estimated that approximately 1.6 million Americans suffer from IBD with 70,000 new cases diagnosed each year. COCCI is interested in data regarding the rapid expansion of telehealth and associated quality of care outcomes within communities of color. While accessibility to telehealth has increased, there are questions about whether health outcomes have improved. Studies have shown that where Black Americans utilized telehealth, those living in lower-income areas were more likely to engage in audio-only telephone visits while patients who were white and from higher-income areas were more likely to engage in video visits, raising questions about quality of care and related health outcomes. A recent NIH study likewise showed that video visits were "significantly lower" for patients 65 and older, male, Black, Indigenous, prefer a language other than English, or enrolled in Medicaid or Medicare and (2) patients who were ages 65 and older, Black or non-English speaking were more reliant on telephone visits than video visits, which may lead to suboptimal treatment or care options for patients
2. Why are you struggling with this issue?
To date, the most available research on telemedicine has been focused on the use of virtual care for maintenance of health, but use of telemedicine for diagnosis – telediagnosis – at this scale is unprecedented, “creating more unknowns than knowns about its impact on diagnostic quality and safety” according to researchers from the Society to Improve Diagnosis in Medicine released an issue brief entitled Improving TeleDiagnosis: A Call to Action. Certain clues about a patient’s condition, lifestyle or response to a new medication may be hard to see via video and nearly impossible to perceive over the phone.
3. What do you want to see changed? How will you know that your issue is improving or has been addressed?
COCCI is interested in ensuring that patients still have available options to see their provider in person should they choose, and not be discouraged from doing so based on reimbursement criteria. It is anticipated that Congress will be undertaking legislative action on telehealth expansion and COCCI strongly supports legislation that expands access to telehealth so that more African Americans and other communities of color will have access to healthcare through these technologies. Having additional information on health outcome impacts to communities of color will be vital information in this process
4. When do you need the evidence report?
Friday, 11/03/2023
5. What will you do with the evidence report?
COCCI will help amplify this report with the COCCI community as well as other stakeholder members, including clinician and patient groups as well as policymakers and allied organizations.
Optional Information About You
What is your role or perspective? Stakeholder Coalition
If you are you making a suggestion on behalf of an organization, please state the name of the organization. Color of Crohn’s and Chronic Illness
May we contact you if we have questions about your nomination? Yes
Supporting Documentation
AHRQ Telehealth Compilation= (PDF, 187 KB)
