Characterizing the Reach of Teledermatology to Underserved Pediatric Populations in Oregon and Washington Compared to Pre‐ and Post‐ COVID In‐Person Visits

Background/Objectives Patients have limited access to pediatric dermatologists. Telehealth has been touted to increase access to underserved areas; however, previous research has shown underutilization in rural communities. This study aimed to characterize the impact of teledermatology on the reach of pediatric dermatologists to geographically underserved populations in the Pacific Northwest during the COVID‐19 pandemic. Methods A single institution retrospective cohort study was performed, analyzing distance‐from‐home‐zip‐code (DHZC) from clinic, payer mix, and language preference of new virtual visits during 4/2020‐3/2021 compared to new in‐person visits in 1/2019‐12/2019 and 4/2020‐3/2021. Results The mean distance from clinic (DHZC) was significantly greater for virtual visits than in‐person (51.8 vs. 36.8 miles; difference: 15.0 miles, 95% CI: 9.8 to 20.1; p < 0.001). The proportion of patients living > 20 miles from clinic was slightly higher in the virtual group (45.9% vs. 42.6%; difference: 3.3 percentage points, 95% CI: −0.5 to 7.1; p = 0.095), though it was not statistically significant. The proportion of patients insured by Medicaid was significantly lower in the virtual group (36.7% vs. 44.1%; difference: −7.5 percentage points, 95% CI: −11.2 to −3.7; p < 0.001). The proportion of English‐speaking patients was higher in the virtual group (97.0% vs. 88.3%; difference: 8.7 percentage points, 95% CI: 7.1 to 10.3; p < 0.001). Conclusions Teledermatology may increase the reach of care provided by pediatric dermatologists to geographically underserved areas in Oregon and Washington. However, patients with Medicaid insurance or non‐English primary languages may face additional barriers, limiting their participation in virtual visits.