Chinese immigrants use China-based telehealth apps to overcome U.S. barriers

A new peer-reviewed study published in DIGITAL HEALTH finds that a substantial share of recent Chinese immigrants in the United States use China-based telehealth applications for medical advice while living in the U.S., often as a response to barriers within the U.S. healthcare system itself.

Researchers from the University of Texas at San Antonio and Sam Houston State University report that 15% of surveyed Chinese immigrants living in the U.S. had used a China-based telehealth app for medical consultation. Importantly, some participants described using these services as a first line of care instead of first seeking U.S.-based healthcare services.

Key factors likely driving transnational telehealth use

The study identified several characteristics strongly associated with the use of China-based telehealth apps:

• Lack of health insurance, which was the strongest predictor of use
• Higher levels of perceived healthcare discrimination in the U.S.
• Younger age and female sex
• Living in areas with large Chinese immigrant communities

Participants cited the lower cost, ease of access, and ability to communicate in their native language as major advantages of China-based platforms. These apps allow users to consult physicians in China via text, image upload, or voice calls-often for less than $10 per consultation.

How immigrants are using these apps

Survey and focus-group data revealed that Chinese immigrants use transnational telehealth apps to address a wide range of concerns, including respiratory infections, musculoskeletal pain, dermatologic issues, medication questions, and assistance translating medical information. Some participants described using advice from China-based physicians to guide subsequent care decisions in the U.S., such as whether to seek imaging, testing, or medication locally.

Implications for U.S. healthcare providers

While transnational telehealth may help bridge cultural and linguistic gaps, the authors caution that reliance on foreign-based medical services also raises concerns for patient safety, continuity of care, and regulatory oversight. China-based clinicians are not subject to U.S. licensing or clinical guidelines, and differences in preventive care standards may result in delayed diagnoses or missed screenings.

Crucially, the study suggests that use of foreign telehealth is not driven solely by convenience, but by structural and interpersonal barriers within U.S. healthcare, including affordability challenges and experiences of discrimination.

Call to action

For healthcare practitioners working with immigrant communities, the findings underscore the importance of:

• Expanding insurance access and navigation support for immigrant patients
• Strengthening culturally competent care
• Improving communication and trust in clinical encounters
• Recognizing that some patients may rely on international medical advice alongside U.S. care

As digital health tools continue to expand across borders, understanding why immigrants seek care outside the U.S. is essential to delivering patient-centered healthcare.