Abstract

Background: At the start of 2020, COVID-19 was declared a pandemic in March 2020. New
methods of providing care for patients were implemented and telemedicine was at the forefront
of that change. However, it is important to assess whether the use of telemedicine has proven to
be effective. More specifically, for the underserved community whom, some would argue,
require the most medical attention, and have the least amount of access.

Objective: The goals of this scoping review were to explore the impact the COVID-19 pandemic
had on the usage of telemedicine and to assess the successes and failures of its implementation,
specifically in the primary care setting for the underserved population.

Methods: We conducted a scoping review after gathering available evidence on peer- and
community-led studies about the impacts of telehealth and telemedicine on access to primary
care specialists in underserved populations during COVID-19. We conducted a search for
peer-reviewed literature published from 2019 to present in the following databases: EBSCOhost,
PubMed, Embase. Our initial search yielded 217 articles. After analysis, 206 articles were
excluded initially. After further review, only 9 out of the 11 final articles were included in the
review.

Results: Forty-four percent of articles (n=4) demonstrated that there was an accelerated use of
telehealth appointments during the COVID-19 pandemic. Two articles (n=2) discussed the use of
telemedicine within underserved populations. Although telehealth use was increased within the
underserved populations, a study done by Cheng and colleagues stated that telehealth utilization
decreased within African-Americans, Latino, Asian-Pacific populations, while increasing in
white populations. Finally, four articles (n=4) recommended the use of telehealth as an
alternative or supplemental approach compared to traditional in-person visits.

Conclusion: With the continuous progression of COVID-19 and overall technology, the role
telemedicine has in healthcare for both healthcare workers and patients is still being
examined.The findings from our scoping review show telemedicine can be beneficial for patients
by increasing access to and continuity of care. Additionally, most studies cited found that
telemedicine can be beneficial for physicians by decreasing average visit time and physician
burnout. However, there are limitations to the use of telemedicine such as issues with policies,
regulations, training, attitudes, and cultures. While the findings suggest that there are both costs
and benefits, it is proposed that a comprehensive approach is necessary to ensure the continued
use of telemedicine. This study has the potential to guide future research to focus on how the
benefits of telemedicine can be used to reconstruct healthcare standard of care workflows to
incorporate telemedicine and potentially mitigate healthcare inequality and lack of access.