Telehealth use has achieved what Stephen Jay Gould, in evolutionary terms, called punctuated equilibrium. It has emerged from relative stasis to rapid growth, and the main reason for this change is the use of telehealth as a primary response to COVID-19. By April, nearly half of all Medicare primary care visits were telehealth encounters, a level consistent with health care encounters more broadly. A central policy discussion now is whether temporary measures in Medicare incentivizing the use of telehealth should be made permanent to ensure telehealth retains a niche in the publicly funded health care ecosystem.
Uptake of telehealth is likely to persist to some degree. The main question is how to integrate this modality into the health care system such that it achieves promised goals and improvements. We argue that polices supporting continued adoption and integration must be deliberate and focus on measurable improvements to clear, systemic shortcomings in health care.
Telehealth During The COVID-19 Pandemic
Telehealth offers strong advantages and benefits for some patients. It markedly increases the convenience and availability of clinical services without long delays or waiting room time. Nevertheless, it is difficult to draw lessons from current utilization data and behavior. The current context of the pandemic is a significant confounder that should give pause to policy makers. Patients perceive having little choice than to seek telehealth services in place of the office visit. There is evidence that patients may be avoiding clinical encounters for even serious conditions, perhaps related to anxiety about the clinical environment. This anxiety and lack of true choice—as well as the novelty and access improvements—are perhaps driving a generous patient perception of telehealth.
There has been plenty of speculative talk about telemedicine for years now, but one result of the pandemic is that there are now sufficient volumes to actually measure its performance. Analyses done by Press Ganey of more than 30,000 patient experience surveys from patients who had telemedicine visits in March and April show that, in some important ways, their experience was comparable to those of patients who saw clinicians in person. Based on the data, patients are overwhelmingly positive about their virtual interactions with their care providers, even when technical issues posed challenges. This is certainly encouraging for the quality of the telehealth interactions, but it will be important to follow this data longitudinally to see if that positive experience is sustained. Already, organizations are seeing decreases in telemedicine use compared to the peak surge months of March and April, possibly due to organizations being able to reopen ambulatory sites and patient preference.
Costs And Benefits Of Telehealth
We need to be clear not only about the long-term outlook of telehealth use but also our expectations of this modality. For example, is the goal…
Read More: Telehealth Should Be Expanded—If It Can Address Today’s Health Care Challenges