Disparities in telemedicine access for Spanish-speaking patients during the COVID-19 crisis

The rapid rise of telemedicine during the COVID-19 pandemic raised the prospect of worsening health care disparities for vulnerable populations. We retrospectively compared pediatric teledermatology visits scheduled during the pandemic (03/17/2020-07/31/2020) with in-person appointments scheduled during the same period in 2019 and found that Spanish-speaking patients had significantly fewer scheduled appointments in 2020 (9% vs 5%, P < .001). Among the telemedicine cohort, Spanish-speaking patients were less likely to have an email address documented within the electronic medical record and less likely to have activated an online patient portal account prior to their visit during the pandemic (45% vs 62%, P = .017, and 23% vs 66%, P < .001, respectively). Our findings suggest that email connectedness may represent a bottleneck in telemedicine access for Spanish-speaking pediatric dermatology patients.