The COVID-19 pandemic has necessitated a new era in medicine in which telehealth appointments are a central aspect of the patient-provider relationship and provide wider access to healthcare.
So what has the healthcare industry learned about using telehealth over the past year, and how can they use these learnings to deliver more accessible, high quality healthcare? for everyone?
Jessica Sweeney-Platt, vice president of research and editorial strategy at athenahealth, has telehealth knowledge drawn from athenahealth’s vast national network data from 18.4 million appointments owned by 60,000 suppliers.
IT news in the healthcare sector interviewed Sweeney-Platt on the topics of Telemedicine Adoption, Use, Planning and Sustainability, seeking his expertise and lessons learned from the Athenahealth Telehealth Data Treasure.
Q: Based on your experience, what was the adoption of telehealth like over the past 12 months? Where have you seen most of the adoption, and in what specialties?
A: Despite the fact that telehealth has been around in one form or another since the 1950s, it was the almost total shutdown of the country in March and April 2020 that really made it a mainstream hotspot. Unsurprisingly, early adoption patterns have followed the path of the most acute COVID-19 outbreaks. We saw early spikes in the northeast and western parts of the country, followed by the Midwest and the south.
The northeastern states initially had the highest percentage (nearly 70% in April 2020) of virtual appointments but were overtaken by the West during the second wave of the pandemic in June and July 2020.
The Midwest has consistently been the second lowest adoption region in percentage (just over 40% in April 2020), and the South is still the lowest in terms of percentage (around 30% in April 2020). The Northeast is also much more consistent than the other regions, with high shadow rates in every state.
In total, we have seen telehealth drop from less than 1% of the total volume of the athena health network to 32%, before settling at around 10 to 11%. The Northeast and the West lead the country for the adoption and sustained volume of telehealth appointments in primary care.
When it comes to specialties, it is not surprising that we have seen mental health and primary care use telehealth the most. Mental health saw the highest percentage of virtual appointments at 33%, followed by primary care at 17%.
Q: You’ve noticed that the practices that have settled into higher usage rates also tend to be practices that had some telehealth experience prior to COVID-19. Please explain what this tells you.
A: This tells us that the adoption of technologies like telehealth may be, in part, due to someone you trust who has already figured out how to make it work in that particular organization. These âchampions of ITâ could help overcome some of the initial uncertainty that comes with any new way of doing things – some of the basic infrastructure and knowledge may already be in place.
This can be useful moving forward as physicians and medical groups seek to implement other technologies. Never underestimate the power of a good pilot or a good experience.
This pattern was only one of the observations that led us to believe that (at least from what we can see in our data) the use of telehealth by patients is motivated more by their practice than by patients. individual preferences.
We saw surprising results when we looked at adoption levels across different racial and ethnic groups, and when we took a closer look, we realized that these patterns were driven by general adoption patterns of practices. As with many other care decisions, if your doctor or healthcare team tells you that this is a safe and acceptable option, patients are likely to follow this advice.
Q: From your experience, you have noticed that planning has an important role to play in the logistics outcomes of telemedicine services. What did you observe? What were the results?
A: Overall, the trends we see in planning virtual tours are quite different from planning in-person tours. We were working from an anonymized data set of 18.4 million appointments that took place between November 1, 2020 and January 31, 2021 and which covers 60,000 providers on the athenahealth network.
What we have seen is that compared to in-person visits (4%), telehealth visits are more likely to occur after hours or on weekends (7%). Telehealth appointments are almost twice as likely to be on the same day as in-person appointments.
Finally, telehealth appointments are generally shorter. They are more likely to last less than 15 minutes (70%), compared to in-person visits (62%). Overall, this gives a picture of patients integrating care on a sort of ‘just in time’ basis, allowing for more spontaneous access, at perhaps more convenient times for people trying to juggle. many other commitments.
Doctors have also told us that telehealth allows them to be flexible in their own schedules. It’s a little more anecdotal, but the doctors and providers we interviewed talk a lot about how telehealth allows them to interact with patients wherever they are.
A doctor spoke at length about the importance to him of being able to take a telehealth visit from his car and then go see his son play basketball, when he would have missed the opportunity before. The impact on vendor timelines is something we’d like to dig a little deeper into over time from a data perspective.
Q: So we’ve seen a remarkable uptake of telemedicine over the past 12 months, but is it going to hold up? What sort of permanence will it achieve?
A: Overall, we are optimistic about the future of telehealth and virtual care. This doesn’t mean that there are still things that the system needs to sort out. A big problem is the long term reimbursement of these services. The question remains open to what extent the regulatory and payment restrictions that were removed in early 2020 will be made permanent. So any prognosis has to have that giant asterisk next to it.
But again, we’re optimistic for the future, mainly because we see virtual care helping to solve real problems. Whether it’s busy people trying to fit a visit to the doctor into their day, or a patient with a chronic illness who just needs a medical check-up and examination, or to Making behavioral health services available to more people in more places, virtual care is a valuable addition to the care toolbox.
And for providers, virtual care has helped reduce cognitive burden and improve work-life balance. They can make telehealth appointments in the office or at home, giving them more freedom, while providing top-notch patient care.
We may have seen an increase in early adoption as a result of COVID-19. But, assuming it remains financially viable, we believe telehealth will have great sustainability, as it provides flexibility, convenience, and lower cost access to those who use it.