Telephone vs. Video Visits During COVID-19: Safety-Net Provider Perspectives

Ji Eun Chang; Zoe Lindenfeld; Stephanie L. Albert; Rachel Massar; Donna Shelley; Lorraine Kwok; Kayla Fennelly; Carolyn A. Berry

doi:10.3122/jabfm.2021.06.210186

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Figure 1.
Percentage of telemedicine visits by modality (telephone vs video). Legend: Percentage of visits made by video or telephone to 36 community health centers that belong to the Community Health Care Association of New York State (CHCANYS) from February to October 2020. Total visits (denominator) include all outpatient visits, including in-person, telephone, and video visits. Before the onset of COVID-19, on February 22, video and telephone visits accounted for 3.4% and 0% of visits, respectively. In the first week following the March 22 NYS stay-at-home order and emergency changes to the NYS Medicaid program, these figures jumped to 14.9% and 22.3%, respectively.

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Table 1.

Characteristics of Participating Sites in Study of Community Health Center Providers' Experience of a Transition to Telemedicine During COVID-19—October to November 2020

Health Center	Size^{^†}	Urban/Rural	Subpopulations	Percentage of Medicaid, CHP, or Dual Eligible Patients^{^‡}	Race/Ethnicity	Prior Telemedicine Experience^{^§}
Site 1	Small	Urban, suburban	I/DD	N/A^{^‖}	N/A^{^‖}	Yes
Site 2	Large	Urban, suburban, rural	Migrant/seasonal farmworker	46.4%	21.6% White, 49.9% Hispanic, 25.6% Black, 2.9% Other	Yes
Site 3	Small	Urban	Persons experiencing homelessness	62.4%	8.2% White, 36.8% Hispanic, 51% Black, 4% Other	Yes
Site 4	Medium	Rural	Migrant/seasonal farmworker	41.6%	35% White, 50.3% Hispanic, 12.1% Black, 2.6% Other	Yes
Site 5	Large	Urban	Persons living with HIV	64.0%	8.2% White, 44.8% Hispanic, 40.3% Black, 6.7% Other	Yes
Site 6	Large	Urban	Immigrant	67.7%	0.7% White, 81.8% Hispanic, 15.2% Black, 2.3% Other	No
Site 7	Large	Rural, suburban	N/A	21.6%	96.8% White, 1.3% Hispanic, 1.3% Black, 0.5% Other	Yes
Site 8	Small	Urban	LGBTQ+	42.9%	36.2% White, 22.8% Hispanic, 32.6% Black, 8.4% Other	No

CHCANYS, Community Health Care Association of New York State; CHP, Capital Health Plan; I/DD, intellectual and developmental disabilities; LGBTQ+, lesbian, gay, bisexual, transgender, and queer+; N/A, not applicable; UDS, Uniform Data System.
↵† Size determined by the number of annual patients reported in 2018 UDS: Large > 50,000; Medium 50,000–10,000; Small < 10,000.
↵‡ Percentage of patients by Medicaid status and race/ethnicity as reported in 2018 UDS.
↵§ Experience in telemedicine indicated by whether they reported any telemedicine visits in the 2018 UDS/known telemedicine experience by CHCANYS staff.
↵‖ Site 1 is a sub-recipient of Site 2 and does not report in 2018 UDS.

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Table 2.
Number of Provider Interviews Conducted by Site and Clinical Service in Study of Community Health Center Providers' Experience of a Transition to Telemedicine During COVID-19—October to November 2020
Health Center Primary Care Behavioral Health Pediatric Total
Site 1 1 1 1 3
Site 2 2 0 1 3
Site 3 2 2 0 4
Site 4 1 1 1 3
Site 5 0 3 0 3
Site 6 1 1 1 3
Site 7 1 1 1 3
Site 8 2 1 0 3
Total 10 10 5 25