Telemedicine for new immigrant children in the US: a tool for equity or another layer of disparity?

Telemedicine refers to the use of digital communication tools to deliver healthcare services. In pediatrics care in the United States (US), it has become an important approach to expand access to primary and subspecialty care while reducing travel demands and improving continuity of care, particularly for children in remote and underserved communities. Evidence consistently shows that telemedicine can supplement in-person visits while maintaining high levels of family satisfaction and clinical effectiveness among American families. This narrative review was developed to assess the applicability of telemedicine for new immigrant families in the US using a structured literature search across PubMed, Scopus, Google Scholar, and Cochrane of published English literature. Peer-reviewed studies were included if they were conducted in the last 50 years and focused on pediatric patients from birth to 21 years of age. Findings were synthesized to evaluate the acceptance, accessibility, feasibility, and applicability of telemedicine for new immigrant children in the US. Across the reviewed literature, telemedicine has meaningful potential in narrowing health disparities faced by new immigrant families such as transportation, specialist shortages, scheduling delays, limited English proficiency, and difficulty navigating the complex healthcare system. Furthermore, telemedicine can connect families with providers who share similar cultural and linguistic backgrounds, thereby strengthening cultural sensitivity and trust. Still, it comes with several obstacles limiting its use among new immigrant families. From digital divide, poor network coverage, low health literacy, privacy concerns, immigration-related concerns, to mistrust, the challenges are numerous. Studies during the COVID-19 pandemic found low acceptance and infeasibility of telemedicine for new immigrant families. However, telemedicine offers multiple opportunities and future directions to better serve immigrant children and their families. Expanding multilingual telehealth platforms and integrating telemedicine access points into schools, community centers, and immigrant resource hubs can enhance accessibility, usability, and acceptance. Pairing telemedicine with artificial intelligence can have huge future potential and might be a tool for inclusive care at lower cost. Furthermore, policy amendments, particularly broader Medicaid telemedicine coverage and mandates for interpreter integration into telemedicine workflows, are essential for promoting more equitable access with higher acceptance and more applicability for new immigrant children in the US.