Key Takeaways
- Patients with both hypertension and diabetes use telehealth at higher rates than single‑condition groups, despite heavier social needs burden.
- Those patients depend more on phone‑only telehealth than video, pointing to a technology access gap.
- Providers offer telehealth inconsistently, with only about one‑in‑five comorbid patients given the option.
What does telehealth access disparities look like for patients with both hypertension and diabetes?
A recent cross‑sectional analysis of the 2022 Health Information National Trends Survey (HINTS) found that 48.0 % of U.S. adults with both hypertension and diabetes used telehealth in the past year. That rate exceeds usage among those with only hypertension (42.9 %) or only diabetes (48.5 %)—but those same patients had the lowest income, lowest education and highest burdens of food and transportation insecurity, signaling a mismatch between need and equitable digital access (jacc.org).
How does modality choice reveal a digital divide?
The study shows phone‑only visits dominate among people with both conditions: 21.4 % relied solely on phone calls, compared with 16.8 % who used video only, and 9.8 % who used both modalities (jacc.org). That pattern suggests the most disadvantaged patients access telehealth in its least feature‑rich form. Patients with diabetes only had higher video‑only use (21.4 %) and lower phone‑only reliance (18.1 %) (jacc.org).
Why aren’t phones enough?
Audio‑only telehealth misses visual cues and complicates physical assessments, medication reviews and self‑management guidance. Research from 2022 shows older age, lack of internet and being uninsured significantly increase odds of audio‑only use (adjusted odds ratios up to 3.58 for those aged 75+) (pmc.ncbi.nlm.nih.gov). Phone‑only users—often the socioeconomically vulnerable—may receive lower‑quality remote care.
What role do provider offers play in access disparities?
The HINTS data reveal telehealth was offered to just 21.5 % of people with both conditions, versus 17.4 % for hypertension alone and 13.2 % for diabetes alone (jacc.org). Even among high‑need patients, provider‑initiated offers remain rare. Provider gatekeeping limits true access, regardless of patient need or willingness.
How can policy close this modality‑based digital divide?
Policymakers could require health systems to track and report modality use by chronic condition and social needs profile. Payers could reimburse audio‑only visits at parity while funding broadband access and digital literacy programs to shift reliance toward video. Safety‑net clinics might deploy loaner tablets or digital navigators targeted at patients with both hypertension and diabetes to ensure richer telehealth access.
FAQ
What do telehealth access disparities tell us about care for chronic patients?
Patients with both hypertension and diabetes, despite highest needs, often rely on phone‑only telehealth—a sign that access isn’t equitable in modality.
Why do patients with chronic conditions use phone‑only telehealth more?
Older age, lack of broadband, lower digital literacy and absence of insurance increase likelihood of using audio‑only visits (pmc.ncbi.nlm.nih.gov).
Does offering telehealth affect use among patients with social needs?
Yes. Only about one‑in‑five comorbid patients were offered telehealth by providers, limiting even modest access (jacc.org).
Is video telehealth always better than phone?
Video allows visual assessment, better engagement and demonstration. Relying on phone may limit clinical effectiveness, especially for chronic disease management.
Can policy reduce telehealth access disparities?
Yes. Funding broadband, supporting device access, reimbursing audio and video equitably and requiring access tracking can narrow the gap.
This article is for general information and is not medical, legal, or financial advice. Telehealth services, prescriptions, and insurance coverage vary by state and provider — verify a provider’s licensing and consult a qualified professional before making care decisions.