Examining Disparities and Device Usage in Outpatient Telemedicine Visits Among Movement Disorders Patients
Vijay Palakuzhy1, Glenn Stebbins1, Christopher Goetz1, Mitra Afshari2
1Rush University Medical Center, 2University of Illinois at Chicago
Objective:
To characterize trends in device usage (mobile-device vs. personal computer (PC)) across demographic factors for video-based telemedicine visits in an urban tertiary Movement Disorders clinic in the U.S.
Background:
The rise of telemedicine during the COVID-19 pandemic has improved healthcare access, but data on device usage and disparities in telemedicine access remains limited. We hypothesized high mobile-device usage and ubiquity of telemedicine utilization across diverse demographic groups.
Design/Methods:
We conducted a retrospective chart review of all televisits with Movement Disorders neurologists at Rush University from March 2020 to March 2023, analyzing visit-specific data embedded within the electronic medical record. We analyzed variations in device usage patterns across different age groups (<20, 20-39, 40-59, 60-79, >80 years), sex, race, and socioeconomic status (zip code median income). Televisits were categorized into mobile-only (smartphones and tablets) or PC-only. Chi-square tests examined the device usage distribution, with effect sizes calculated to assess the strength of differences. Logistic regression analyzed the odds of mobile-only usage.
Results:
We identified 2,181 unique patient televisits. 87.8% of televisits were accessed with mobile-devices (n=1,915) and only 12.2% with PCs (n=266). The mean age of mobile users was slightly lower at 62.1 vs. 64.9 years in PC-users (p=0.02) with more than half of patients in the 60-79 age group (56.5%). The Chi-Square analysis revealed statistically significant but clinically insignificant results due to small effect sizes (both 0.07): younger patients (<20) showed the highest mobile use (p=0.03) and the lowest income quintile had 100% mobile usage while the highest quintile had the lowest (p=0.03). Logistic regression revealed no significant predictors of mobile usage.
Conclusions:
Mobile-device use for telemedicine in Movement Disorders is widespread across all demographics. These findings emphasize the role smartphones play in facilitating access to telemedicine, suggesting that enhancing mobile-based telemedicine applications could improve healthcare equity particularly for vulnerable populations.
Disclaimer: Abstracts were not reviewed by Neurology® and do not reflect the views of Neurology® editors or staff.