The Disparities of Video Telemedicine in Urology

The acceleration of video telemedicine during the COVID-19 pandemic has shifted the care delivery paradigm. While video visits are more easily accessible and can save patients and providers valuable time, there exist disparities in access and digital literacy.

Using machine learning, the Department of Urology, Department of Medicine, Telehealth Resource Center, and UCSF CDHI informatics developed models to determine predictors of video visit outcomes in the high-volume UCSF urology practice. Approximately 6,000 patients and their first video visits were analyzed. The primary outcome was the status of completion of that video visit (successful completion was narrowly defined as being able to establish a video connection).

The team found:

• Latinx, Medicare, and Medicaid patients were significantly more likely to have video visit failures.

• Patients with men’s health issues (e.g. erectile dysfunction/vasectomy evaluation, etc.) and lower urinary tract syndromes were more likely to have video visit successes.

Understanding which factors may play a role in a patient’s inability to successfully initiate a video visit allows for targeted interventions to ensure equity of access to telemedicine. Future interventions to improve telemedicine usage rates may prioritize patients with non-commercial insurance, patients of lower socioeconomic status, Hispanic or Latino patients, or patients less engaged in the digital health infrastructure.

The team hopes to continue building on the existing modeling infrastructure to develop similar analysis across other UCSF clinics and practices.

Learn more:

• View the UC Health Improvement Symposium 2022 poster

• Read the published article