NYC Health + Hospitals Corporation

Since the start of the COVID-19 pandemic, New York State has seen rapid expansion of telehealth usage spurred by the need for patients to access care when health care facilities were operating at limited capacity.

Although the explosion in telehealth tapered off as facilities reopened, increased use of telehealth is here to stay. However, the expansion of telehealth has not benefitted all patients equally, with rural and low-income populations and people of color experiencing more barriers and lower levels of utilization. Older adults, as well as non-English speakers, are also less likely to access remote care. A number of barriers limit access, such as lower digital and health literacy; discomfort and confusion; and lack of access to internet connectivity. As telehealth continues its expansion and evolution, it should benefit diverse, low-income patients and promote health equity. In 2021, NYHealth awarded NYC Health + Hospitals Corporation (H+H), which serves 1.3 million New Yorkers each year, a grant to promote the effective and equitable implementation of telehealth for low-income and otherwise marginalized patients. NYHealth also supported a complementary initiative with AIRnyc.

Under this grant, H+H designed engagement strategies for patients that reflect their needs, preferences, and digital and health literacy levels. It implemented a new telehealth video platform with added language interpretation features and other patient-friendly functionality. H+H also implemented a 24/7 hotline to help patients enroll in its online patient portal. Telehealth patient navigators offered weekly video visits for patients to help them confidently navigate the system and answer any questions. Navigators also worked with community partners to develop telehealth education materials for patients in multiple languages to address common questions and concerns. H+H assessed patient perspectives, needs, and interests regarding telehealth, as well as conducted routine surveys on accessibility, usability, and patient impressions. It also evaluated the barriers to telehealth participation and which interventions work best, sharing best practices with other safety-net providers.

See related publications:

• Patient Characteristics Associated with Telehealth Scheduling and Completion in Primary Care at a Large, Urban Public Healthcare System
• Primary care utilization among telehealth users and non-users at a large urban public healthcare system
• Patient satisfaction with telehealth versus in‐person visits during COVID‐19 at a large, public healthcare system
• Appointment Non-attendance for Telehealth Versus In-Person Primary Care Visits at a Large Public Healthcare System