When it comes to telehealth it’s not numbers

Business Insider formed a relationship with eMarketer for so-called “intelligence.” Their report on telehealth has numbers, but that’s not what’s important. We need to understand “why” people are using telehealth and for what purposes versus an in-office visit. In-office visits also have more benefits.

Here is a quote from the report that is debatable at best “over the next few years, telehealth will remain the domain of the younger digital natives. Older generations that have used the service may become converts. Still, they are more likely to continue use because of complex medical conditions or a nonclinical factor such as lack of transportation”.

OK, so where to start…First, let’s ask a fundamental question “why are people using telehealth? Convenience is a crucial reason, but what do patients consider convenience versus what physicians call convenience?

According to the AMA. What patients said about telehealth showed that they had positive experiences and didn’t want to see it go away. Among those surveyed:

  • 79% were very satisfied with the care received during their last telehealth visit.
  • 81% said the provider was thorough.
  • 84% were confident their personal information was secure and private during the visit.
  • 83% believed the quality of the patient-physician communication was good.
  • 73% will continue to use telehealth services in the future.
  • 41% would have chosen telehealth over an in-person appointment for their last visit, even if both required a copay.

What about physicians?

On the other side of the video chat, 68% of physicians told researchers they were personally motivated to increase the use of telehealth in their practice, and 71% said their organization’s leadership was encouraged.

Here are the top five services physicians surveyed say they want to offer after the COVID-19 pandemic has ended, along with the percentage who said they wanted to continue each service:

  • Chronic disease management—73%.
  • Medical management—64%.
  • Care coordination—60%.
  • Preventative care—53%.
  • Hospital or emergency department follow-up—48%.

Today, with that infection risk easing for those who have been vaccinated, many patients nevertheless prefer that doctors, nurses, and other health workers be able to examine and talk to them in person.

One finding from a poll by NPR, the Robert Wood Johnson Foundation, and the T.H. Chan School of Public Health at Harvard surveyed patients in August and September. Around 42% of respondents said someone in their household had used telehealth.

 Given the opportunity, the overwhelming majority of patients are choosing to see their doctors in person again. Last May, only 67% of bookings on Zocdoc were for in-person appointments. A little over one year later, that number is back up to 89% and is likely to rise as more patients resume seeing their doctors face-to-face.

There are things that virtual medicine can miss as well, studies suggest. One study showed that commercial telemedicine services were more likely to prescribe antibiotics for children’s respiratory infections as a primary care doctor at an in-person visit. That’s in part because if you can’t see into the ear to observe a bulging drum, for example, the safer course is to overtreat — even though that’s contrary to prescribing guidelines intended to prevent antibiotic resistance.

It’s tempting to look at this data and conclude that telehealth is the Segway of medicine—a much-hyped innovation that failed to achieve long-term traction. The reality, however, is more nuanced. In-person appointments are surging, but at the same time, there are several areas where telehealth has caught on and is likely to stick.

Insurers are already rolling back their willingness to pay for telehealth visits earlier in the pandemic. And providers and insurers are battling over reimbursement levels. Is a video call worth the same as an in-person doctor’s visit? If a commercial telemedicine-only doctor determines a patient requires an in-person assessment, is the fee discounted or waived? And how is a smart referral done if that telemedicine provider is thousands of miles away?

So is telehealth here to stay? Yes, but it doesn’t replace an in-office visit. It can be used as a convenience tool, but it will never replace in-person healthcare.

The pandemic has demonstrated that virtual medicine is excellent for many simple visits. But many new types of telemedicine promoted by start-ups more clearly benefit providers’ and investors’ pockets, rather than yielding more convenient, high-quality, and cost-effective medicine for patients.