Can telemedicine help close care gaps?

The use of telemedicine has increased significantly during the COVID-19 pandemic, as patients are more concerned about traveling to the doctor’s office and sitting with other patients in the waiting room for any period of time. However, telemedicine has been seen as a viable solution for certain care gaps for some time.

The Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services defines telehealth as the use of electronic information and telecommunications technologies to support and promote long-distance clinical health care, patient and professional health-related education, public health, and health administration. Technologies include videoconferencing, the internet, store-and-forward imaging, streaming media, and terrestrial and wireless communications.

Telehealth applications include:

• Live (synchronous) videoconferencing: a two-way audiovisual link between a patient and a care provider.
• Store-and-forward (asynchronous) videoconferencing: transmission of a recorded health history to a health practitioner, usually a specialist.
• Remote patient monitoring (RPM): the use of connected electronic tools to record personal health and medical data in one location for review by a provider in another location, usually at a different time.
• Mobile health (mHealth): health care and public health information provided through mobile devices. The information may include general educational information, targeted texts, and notifications about disease outbreaks.

Learn more about transitioning your practice to telehealth using Elation.

A study that examined 125.8 million primary care visits in the 10 calendar quarters between Q1 of 2018 and Q2 of 2020 found that in response to the pandemic and shelter-in-place orders earlier this year, providers aggressively turned to telehealth for care delivery, when possible. However, the research also shows that primary care visits still dropped 21 percent during the second quarter of 2020, even after accounting for telehealth appointments.

The study specifically revealed that in the eight calendar quarters between Jan. 1, 2018, and Dec. 31, 2019, between 122.4 million and 130.3 million quarterly primary care visits occurred in the U.S., 93 percent of which were office-based. In 2020, meanwhile, the total number of encounters decreased to 117.9 million in Q1 and 99.3 million in Q2, a decrease of 27 million visits, or 21.4 percent from the average of Q2 levels during 2018 and 2019.

Office-based visits decreased 50 percent (59.1 million visits) in Q2 of 2020 compared with Q2 2018-2019, while telemedicine visits increased from 1 percent of total Q2 2018-2019 visits (1.4 million quarterly visits) to 4 percent in Q1 of 2020 (4.8 million visits), before skyrocketing up to 35.3 percent in Q2 of 2020 (35 million visits). Telemedicine is helping to fill in the care gaps, especially during the COVID-19 pandemic, for those patients who need access to quality healthcare.

Telemedicine has been shown to be particularly effective in places where more traditional office-based practices are less readily available and in areas where patients may be challenged in being able to travel to a provider’s physical office to access healthcare. As AAFP points out, allowing patients to receive care closer to home significantly reduces their costs and is much more convenient for them and their families.

Tate Hinkle, M.D., a family physician in Alexander City, AL, writing for AAFP, also emphasizes that “Although telemedicine has expanded access and improved care for patients, we have to ensure that we don’t forget that face-to-face, personal patient care is still the best way for us to care for patients when possible, especially when difficult news must be delivered.”

Even as telemedicine increases and independent physicians become better equipped, through remote options, to provide the quality healthcare patients need, the focus still needs to be on the personal relationship between the patient and the primary care physician. As Dr. Hinkle explains, “We need to make sure that telemedicine allows us to give our patients the best care we can as family physicians, not simply care that’s more convenient.”