• Omolola E Adepoju, Luan Tran, Rosemary Agwuncha, Minji Chae, Jason Franco-Castano, Tracy Angelocci, and Winston Liaw.
• From University of Houston College of Medicine, Houston, TX (OA, LT, RA, WL); Humana Integrated Health System Sciences Institute at the University of Houston, Houston, TX (OA, MC, JFC); Lone Star Circle of Care, Georgetown, TX (TA). oadepoju@uh.edu.
• J Am Board Fam Med. 2022 May 1; 35 (3): 457-464.

IntroductionIncreased telemedicine implementation may promote primary care access. However, gaps in telemedicine uptake may perpetuate existing disparities in primary care access. This study assessed provider- and patient-level factors associated with telemedicine use in community-based family practice clinics.MethodsThis retrospective study used electronic medical records data from a large Federally Qualified Health Center. A 3-level mixed-effects logistic regression model explored predictors of telemedicine use, with provider and patient as random effects.ResultsThe analytic sample included 37,428 unique patients with 106,567 primary care encounters with 42 family medicine providers. Fifty-seven percent of the sample identified as Hispanic, 28% non-Hispanic White, and 11% non-Hispanic Black. Compared to Hispanics, non-Hispanic White patients had 61% higher odds of a telemedicine visit, and non-Hispanic Black patients had 32% higher odds of a telemedicine visit. The odds of telemedicine use were lower for those who were uninsured. Those residing in metropolitan areas or medically underserved areas had greater odds of a telemedicine appointment. Commute time exhibited a dose-response relationship with telemedicine use. Provider characteristics were not significantly associated with telemedicine use.DiscussionWhile provider characteristics were not associated with telemedicine use, greater focus on patient characteristics specific to the population served is necessary.© Copyright 2022 by the American Board of Family Medicine.

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