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Abstract Objective Through the coronavirus disease 2019 (COVID-19) pandemic, telemedicine became a necessary entry point into the process of diagnosis, triage and treatment. Racial and ethnic disparities in health care have been well documented in COVID-19 with respect to risk of infection and in-hospital outcomes once admitted, and here we assess disparities in those who access healthcare via telemedicine for COVID-19 . Materials and Methods Electronic health record data of patients at New York University Langone Health between March 19th and April 30, 2020 were used to conduct descriptive and multilevel regression analyses with respect to visit type (telemedicine or in-person), suspected COVID diagnosis and COVID test results. Results Controlling for individual and community-level attributes, Black patients had 0.6 times the adjusted odds (95%CI:0.58-0.63) of accessing care through telemedicine compared to white patients, though they are increasingly accessing telemedicine for urgent care, driven by a younger and female population. COVID diagnoses were significantly more likely for Black versus white telemedicine patients. Discussion There are disparities for Black patients accessing telemedicine, however increased uptake by young, female Black patients. Mean income and decreased mean household size of Zip code were also significantly related to telemedicine use. Conclusion Telemedicine access disparities reflect those in in-person healthcare access. Roots of disparate use are complex and reflect individual, community, and structural factors, including their intersection; many of which are due to systemic racism. Evidence regarding disparities that manifest through telemedicine can be used to inform tool design and systemic efforts to promote digital health equity. 

Abstract This study provides data on the feasibility and impact of video-enabled telemedicine use among patients and providers and its impact on urgent and nonurgent healthcare delivery from one large health system (NYU Langone Health) at the epicenter of the coronavirus disease 2019 (COVID-19) outbreak in the United States. Between March 2nd and April 14th 2020, telemedicine visits increased from 102.4 daily to 801.6 daily. (683% increase) in urgent care after the system-wide expansion of virtual urgent care staff in response to COVID-19. Of all virtual visits post expansion, 56.2% and 17.6% urgent and nonurgent visits, respectively, were COVID-19–related. Telemedicine usage was highest by patients 20 to 44 years of age, particularly for urgent care. The COVID-19 pandemic has driven rapid expansion of telemedicine use for urgent care and nonurgent care visits beyond baseline periods. This reflects an important change in telemedicine that other institutions facing the COVID-19 pandemic should anticipate.