​Summary: Telehealth services that allow remote communication between the patient and the clinical team are an emerging part of care delivery. Given language barriers, patients with limited English proficiency present a unique set of challenges in integrating telehealth and ensuring equity. Using data from 84,419 respondents in the 2015–2018 California Health Interview Survey, authors assessed the association between limited English proficiency and telehealth use (telephone and video visits) and evaluated the impact of telehealth use on health care access and use.

Findings: Authors found that patients with limited English proficiency had lower rates of telehealth use (4.8 percent versus 12.3 percent) compared with proficient English speakers. In weighted multivariable logistic regression, patients with limited English proficiency still had about half the odds of using telehealth. Telehealth use was associated with increased emergency department use for all patients.

Authors’ findings suggest that patients with limited English proficiency should be included as part of the telehealth equity conversation, especially as telehealth deployment among such patients presents novel challenges to providing linguistically appropriate care. Telehealth has the potential to address disparities, but only if it meets all patients’ needs, no matter what language they speak; otherwise, evidence of digital divides will continue to appear. Policymakers and providers must pursue linguistically equitable care in emerging technologies. The rapid shift to telehealth during the COVID-19 pandemic along with the disproportionate impact on underserved populations heightens the importance of technology equity as a health policy and public health focus.