Telehealth Use and Mammogram Utilization: Does This Relationship Differ Based on Perceived Barrier to Telehealth Use?

BACKGROUND: The objective of the study was to understand barriers to telehealth use among women and to examine mammography uptake in relation to these barriers. For this purpose, we implemented a survey to explore barriers to telehealth and use of cancer-preventative services. METHODS: Recruitment was based on electronic health record data from MultiCare Health System. Recruitment and enrollment of patients was initiated in 2024 and ended in March 2025, when the target sample size of 1,000 was reached. Women, aged between 50 and 75 years, were surveyed. Women with a personal history of breast cancer were excluded from the analyses. Among those included, 614 women had received virtual care in the previous 5 years, and 265 women had not received virtual care. Women who had 5 or more mammograms in the last 10 years were classified as 'optimal mammogram utilizers'. Those reporting 0-4 mammograms were identified as 'mammogram under-utilizers'. Logistic regression analyses examined the association of telehealth use with mammogram utilization. RESULTS: Compared to women who received virtual health care visits, women whose providers did not offer virtual care had significantly lower odds of optimal mammogram utilization. Lack of receipt of virtual care due to other reasons (i.e., technology issues and lack of preference/need) was not significantly associated with mammogram utilization. CONCLUSIONS: Study findings suggest that greater provider acceptance and use of telehealth for delivery of health care services could be associated with better mammogram utilization. Understanding barriers to provider acceptance of telehealth could inform efforts to expand telehealth.