Dec. 4, 2018
Dive
Brief:
- Despite growing interest in
telehealth options, relatively few doctors are using the service, a
new study in
Health Affairs finds.
- In 2016, just 15.4% of doctors worked
in practices that employed telemedicine for a wide range of patient
interactions — from e-visits to storing and forwarding diagnostic imaging
results, according to American Medical Association researchers who
reviewed data from 3,500 doctors in that year's Physician Practice
Benchmark Survey.
- During that time, 11.2% of doctors
worked in practices that used telemedicine for interactions between
doctors and other healthcare professionals. In both cases, specialties and
larger practices were more likely to deploy the technology than small and
general practices.
Dive
Insight:
A
number of challenges contribute to low uptake of telehealth, including
regulatory barriers, lack of internet connectivity, prohibitive costs and
reluctance of some physicians and patients to try something new.
In
a report to Congress earlier this month, CMS blamed current Medicare law —
which requires patients be in an originating site when receiving telehealth
services — for the lack of the technology's usage among older Americans. Such
sites must be in a rural health professional shortage area or a county outside
a metropolitan statistical area or must be participating in a federal
telemedicine project to use telehealth services. In 2016, just 0.25% of the 35
million fee-for-service Medicare enrollees use used the option.
By
contrast, telehealth use among commercially
insured appears to be catching on and growing fast. From 2015
to 2014, annual telehealth visits grew at an annual rate of 52%, and the pace surged
to 261% between 2015 and 2017, according to a recent JAMA study.
In
the AMA study, radiologists (39.5%), psychiatrists (27.8%) and cardiologists
(24.1%) had the highest telehealth use, but their reasons for using it varied.
For example, radiologists frequently used the modality to diagnose patients and
store and forward data. Psychiatrists like the option for patient-facing video
conferences, while cardiologists employed it to monitor patients remotely and
manage chronic diseases.
Videoconferencing
was also the most common telehealth modality, making up 12.6% of physician use.
Insurance coverage may explain that finding, as many state parity laws refer to
videoconferencing in definitions of telehealth, according to the study. Still,
the data did not show an association between telehealth use and state parity
laws. Rather, the major barrier may be costs of purchasing and setting up a
telemedicine program.
"Our
work suggests that despite regulatory and legislative changes designed to encourage
the use of telemedicine, the financial burden of implementing it may be a
continuing barrier, especially for small practices," the authors write.
"Even after we controlled for specialty differences, we found that
physicians in larger practices and ones that were not physician owned were more
likely to report the their practices used telemedicine for interactions with
both patients and health care professionals."
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