biostudies-literatureUnknown30(3)Tierney AA<b><i>Background:</i></b> Telemedicine systems were rapidly implemented in response to COVID-19. However, little is known about their effectiveness, acceptability, and sustainability for safety net populations. This study systematically reviewed primary care telemedicine implementation and effectiveness in safety net settings. <b><i>Methods:</i></b> We searched PubMed for peer-reviewed articles on telemedicine implementation from 2013 to 2021. The search was done between June and December 2021. Included articles focused on health care organizations that primarily serve low-income and/or rural populations in the United States. We screened 244 articles from an initial search of 343 articles and extracted and analyzed data from <i>N</i> = 45 articles. <b><i>Results:</i></b> Nine (20%) of 45 articles were randomized controlled trials. <i>N</i> = 22 reported findings for at least one marginalized group (i.e., racial/ethnic minority, 65 years+, limited English proficiency). Only <i>n</i> = 19 (42%) included African American/Black patients in demographics descriptions, <i>n</i> = 14 (31%) LatinX/Hispanic patients, <i>n</i> = 4 (9%) Asian patients, <i>n</i> = 4 (9%) patients aged 65+ years, and <i>n</i> = 4 (9%) patients with limited English proficiency. Results show telemedicine can provide high-quality primary care that is more accessible and affordable. Fifteen studies assessed barriers and facilitators to telemedicine implementation. Common barriers were billing/administrative workflow disruption (<i>n</i> = 9, 20%), broadband access/quality (<i>n</i> = 5, 11%), and patient preference for in-person care (<i>n</i> = 4, 9%). Facilitators included efficiency gains (<i>n</i> = 6, 13%), patient acceptance (<i>n</i> = 3, 7%), and enhanced access (<i>n</i> = 3, 7%). <b><i>Conclusions:</i></b> Telemedicine is an acceptable care modality to deliver primary care in safety net settings. Future studies should compare telemedicine and in-person care quality and test strategies to improve telemedicine implementation in safety net settings.Telemedicine journal and e-health : the official journal of the American Telemedicine Association622-641https://www.ebi.ac.uk/biostudies/studies/S-EPMC10924064biostudies-literatureTelemedicine Implementation for Safety Net Populations: A Systematic Review.PMC10924064Rodriguez HPTierney AAMosqueda MPayan DDCesena GFrehn JLfalseTelemedicine Implementation for Safety Net Populations: A Systematic Review.<b><i>Background:</i></b> Telemedicine systems were rapidly implemented in response to COVID-19. However, little is known about their effectiveness, acceptability, and sustainability for safety net populations. This study systematically reviewed primary care telemedicine implementation and effectiveness in safety net settings. <b><i>Methods:</i></b> We searched PubMed for peer-reviewed articles on telemedicine implementation from 2013 to 2021. The search was done between June and December 2021. Included articles focused on health care organizations that primarily serve low-income and/or rural populations in the United States. We screened 244 articles from an initial search of 343 articles and extracted and analyzed data from <i>N</i> = 45 articles. <b><i>Results:</i></b> Nine (20%) of 45 articles were randomized controlled trials. <i>N</i> = 22 reported findings for at least one marginalized group (i.e., racial/ethnic minority, 65 years+, limited English proficiency). Only <i>n</i> = 19 (42%) included African American/Black patients in demographics descriptions, <i>n</i> = 14 (31%) LatinX/Hispanic patients, <i>n</i> = 4 (9%) Asian patients, <i>n</i> = 4 (9%) patients aged 65+ years, and <i>n</i> = 4 (9%) patients with limited English proficiency. Results show telemedicine can provide high-quality primary care that is more accessible and affordable. Fifteen studies assessed barriers and facilitators to telemedicine implementation. Common barriers were billing/administrative workflow disruption (<i>n</i> = 9, 20%), broadband access/quality (<i>n</i> = 5, 11%), and patient preference for in-person care (<i>n</i> = 4, 9%). Facilitators included efficiency gains (<i>n</i> = 6, 13%), patient acceptance (<i>n</i> = 3, 7%), and enhanced access (<i>n</i> = 3, 7%). <b><i>Conclusions:</i></b> Telemedicine is an acceptable care modality to deliver primary care in safety net settings. Future studies should compare telemedicine and in-person care quality and test strategies to improve telemedicine implementation in safety net settings.2024-01-01T00:00:00Z2024 Mar2025-04-04T01:14:06.281Z2025-04-04T01:14:06.281ZS-EPMC109240643770799710.1089/tmj.2023.0260