News|Articles|March 10, 2026

Telemedicine Use Remains Elevated but Access Gaps Persist After COVID-19

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Key Takeaways

Longitudinal EHR analysis (2019–2024) captured 46.1 million outpatient encounters; 4.9% were telemedicine, enabling characterization of post-acute-pandemic stabilization rather than early-pandemic snapshots.
Digital access and care continuity correlated strongly with telemedicine uptake, including patient portal use (OR 1.44) and returning-visit status, while new-patient encounters were markedly less likely (OR 0.46).
Age, sex, and comorbidity influenced utilization, with steep reductions among patients ≥65 years (OR 0.47) and modestly lower use among men (OR 0.90).
Racial and ethnic inequities persisted after adjustment, with lower telemedicine odds among Asian (OR 0.82), non-Hispanic Black (OR 0.88), and Hispanic patients (OR 0.94) versus non-Hispanic White patients.
Specialty patterns diverged, as psychiatry/neurology/sleep medicine sustained ~20%–35% peak utilization into 2024, whereas many medical and surgical fields regressed toward ~5% after 2021.

A study of 46 million visits finds telemedicine remains above prepandemic levels, but older adults and minority groups are less likely to use virtual care.

Telemedicine usage spiked during the COVID-19 pandemic and is still significantly higher than pre-pandemic levels. Yet disparate access remains a pivotal issue as various underserved patient demographics have lower utilization, suggesting an inequitable opportunity to leverage this health tool.¹

These findings, recently published in the Journal of General Internal Medicine, underscore the importance of equitable access to health care tools and the need for policies that ensure fair adoption of telemedicine services. Telemedicine use was about 1% from 2019 to early 2020, and at the onset of the COVID-19 pandemic in early March 2020, the percentage jumped to 17% within a month. For the remainder of 2020, the rate fluctuated between 8% and 13% and only began to decline in 2021, stabilizing at around 4% to 6% in 2022 and onward.

This study, unlike others, analyzed long-term trends of telemedicine utilization across broader patient demographics to fill in data gaps from other studies. Prior research has been inconsistent, especially when assessing utilization across patients’ race and ethnicity. Previous studies have also shown rates of telemedicine use in primary care and psychiatry that exceed those of specialty medicine; however, the data are limited on the long-term impact.^1,2

Researchers collected electronic health record data between January 1, 2019, and September 30, 2024, from 5 hospitals within Penn Medicine. They identified 46,149,734 outpatient encounters among 2,248,342 patients. Out of the total visits, 4.9% were completed via telemedicine and 95.1% occurred in-person.

Patient demographics data stated that of all the visits, 62.7% were women, 61.4% were non-Hispanic White, 22.6% were non-Hispanic Black, 4.8% were Hispanic, and 4.7% were non-Hispanic Asian. Furthermore, 78.7% were users of the patient portal.

Overall, patients more likely to have completed telemedicine visits were women, younger adults, and unmarried (OR, 1.10; 95% CI, 1.10-1.11), patient portal users (OR, 1.44; 95% CI, 1.43-1.45); returning patients; and those with lower Charlson Comorbidity Index scores. Patients who had a longer distance from their home to the place of health care service were also associated with higher telemedicine usage (5 to 15 miles: OR, 1.04; 95% CI, 1.03-1.04; ≥ 15 miles: OR, 1.42; 95% CI, 1.41–1.42).

By contrast, older patients were less likely to use telemedicine compared with patients younger than 40 years (40-64 years: OR, 0.67; 95% CI, 0.67-0.67; ≥ 65 years: OR, 0.47; 95% CI, 0.47-0.47), in addition to males (OR: 0.90; 95% CI, 0.90-0.91) and new patient visits (OR: 0.46; 95% CI, 0.46-0.47).

When factoring for race and ethnicity, researchers saw that Asian (OR, 0.82; 95% CI; 0.82-0.83), Hispanic (OR, 0.94; 95% CI, 0.94-0.95), and non-Hispanic Black patients (OR, 0.88; 95% CI, 0.88-0.89) were also less likely to receive care via telemedicine compared with non-Hispanic White patients.

Of the specialties using telemedicine, the majority peaked toward the end of 2020 and into 2021. For example, sleep medicine, psychiatry, and neurology peaked the most out of the other assessed specialties, with a utilization between 20% and 35%. In comparison, family medicine, internal medicine, surgery, and obstetrics and gynecology peaked between 10% and 15% but declined to 5%. This is unlike sleep medicine, psychiatry, and neurology, which remained relatively high into 2024.¹ Behavioral health is another specialty where telemedicine utilization continues to rise.²

Overall, primary care visits (OR, 1.23; 95% CI, 1.22-1.24) were associated with higher telemedicine use compared with specialty care. These findings suggest that policies shaping telemedicine adoption have varying impacts on different patient populations. Telemedicine is an equitable health care tool that can improve access to care for underserved or disadvantaged patient populations.

This study was limited, as the data were specific to Penn Medicine and may not be generalizable to other health care settings with different patient populations and telemedicine infrastructures. Furthermore, telemedicine adoption was influenced by patient preference, institutional scheduling rules, and provider-driven biases.

“Future research should explore the impact of these system-level constraints on telemedicine availability and uptake,” the study authors concluded.

References
1. ZhangB, Li L, Lu Y, et al. Temporal trends and sociodemographic differences in telemedicine utilization, 2019–2024. J Gen Intern Med. Published online February 11, 2026. doi:10.1007/s11606-025-09964-y

2. Mandal S, Wiesenfeld BM, Mann DM, Nov O. The “new” new normal: changes in telemedicine utilization since COVID-19. AJMC. 2025;31(3): e74-e78. doi:10.37765/ajmc.2025.89700