17 Mar What is the Future of Telehealth?
Telehealth refers to the use of electronic information and telecommunication technologies to support long-distance health care, patient and professional health-related education, public health and health administration. During the early months of the COVID-19 pandemic, physicians and healthcare systems adjusted the way they deliver care using methods that do not rely on in-person services. Telehealth, including virtual doctor visits, has played a critical role in providing necessary care to patients while minimizing potential infectious exposures.
According to the Centers for Disease Control (CDC), Telehealth can improve patient health outcomes by avoiding the negative consequences of delayed care. Remote access to healthcare services may also increase participation for those who are medically or socially vulnerable, or who do not have ready access to providers. In addition, it can help preserve the patient-provider relationship at times when an in-person visit is not practical or feasible.
From March through August 2021, 8 percent of all outpatient visits were conducted via Telehealth – down from 13 percent in the first six months of the pandemic, but well above pre-pandemic levels when Telehealth accounted for a negligible share of outpatient visits. Although the use of Telehealth has decreased since its pandemic peak, a new KFF-Epic Research analysis suggests a more permanent shift in how patients receive care.
The analysis examines data of more than 126 million patients from hospitals and clinics across the country, and looks at Telehealth use by chronic condition, age, location and gender. Overall, the study reveals that, while the total number of outpatient visits has returned to pre-pandemic levels, Telehealth visits remain elevated. Here is a summary of key findings:
- Adults ages 65 and older relied on Telehealth for a smaller share (5 percent) of outpatient visits between March and August 2021 than younger adults (8 percent) and children (11 percent). Telehealth is often considered a way to improve access to care for older adults. However, this group has had lower retention of Telehealth than younger people. These differences may reflect differences in enrollees’ comfort with the technology, internet access and the type of services used.
- Patients in rural and urban areas used Telehealth at similar rates between March and August 2021. Many consider virtual care as an alternative in areas which have physician shortages. However, urban and rural residents had similar share of Telehealth outpatient visits in the first six months of the pandemic (13 percent vs. 12 percent). By the spring and summer of 2021, Telehealth visits in both urban and rural areas had declined to 8 percent and 10 percent of visits respectively.
- Men and women were using Telehealth at approximately the same rate – 8 percent of women’s outpatient visits were conducted via Telehealth between March and August 2021 vs. 7 percent of men’s visits.
- Telehealth use for chronic condition management has decreased over the pandemic, but remains elevated over pre-pandemic levels. The growth of Telehealth may provide persons with chronic conditions – such as obesity, asthma, hypertension, diabetes or thyroid disorders – greater access to services to manage their conditions. Some have proposed increased use of Telehealth for care management, such as helping patients monitor their disease and adherence to treatments remotely.
Overall, the analysis acknowledges the large role Telehealth has played in addressing health needs during the COVID-19 pandemic, particularly when in-person services were delayed or postponed to avoid potential spread of the virus. Governments, private insurers, employers and providers have worked to make Telehealth more accessible through changes in payment, coverage and licensing policies.
Combined, these factors have significantly increased Telehealth access and use among publicly and privately insured people. While Telehealth was a negligible share of outpatient visits before the pandemic, the number of services delivered remotely remains elevated.
It is not clear what role Telehealth will play in the future and for what types of health services. However, Telehealth may continue to improve access for elderly people with chronic care management needs, rural residents without access to providers and people who do not require in-person evaluations. In addition to clinical guidelines, regulatory and coverage policies will determine Telehealth use in the months ahead.