A
RAND survey finds that telehealth use for mental health care has outpaced that
for physical care during the early stages of the pandemic, and many people
turned to telehealth specifically to connect with their own doctors.
January 12, 2021 - A new study finds that the
sharp increase in telehealth use during the height of the coronavirus pandemic
was driven more by people seeking mental health services than for physical
ailments.
The study, coordinated by researchers at RAND and published in
the Journal of General Internal Medicine, documents
a population turning to connected health in unprecedented numbers as the
COVID-19 crisis pushed providers to reduce in-person care. It also points out
that the momentum might not be sustainable after the pandemic if federal and
state officials don’t take steps to ensure easy and equitable access.
“While the increased use of telehealth was widespread, some
groups of Americans reported using the services less often than others,” Dr.
Shira H. Fischer, the study's lead author and a physician researcher at
RAND, said in a press
release. “If telehealth use is going to remain high, we need to
ensure equity of access, particularly for behavioral health care where
education, age, and gender were all associated with levels of use.”
The study, based on more than 2,000 responses to survey
issued in May 2020, found that almost half turned to telehealth to continue
accessing care when the pandemic took hold. Of that number, about 54 percent
said they were seeking help for a behavioral health concern, while 43 percent
sought treatment for a chronic physical health condition.
Prior to the pandemic, some 40 percent were seeking care for
a chronic health condition, while only 15 percent were seeking care for a
behavioral health concern.
The numbers point to a strong need for increased access to
and coverage of telemental health after the pandemic, especially in light of
rising rates of depression, stress and substance abuse.
Another take-away from the survey is more troubling.
According to researchers, the dramatic increase in
telehealth was driven by patients who wanted to continue seeing their own
doctors, many of whom shut down their offices and switched to virtual care to
reduce the risk of contracting the virus. As the public health emergency ends
and providers return to in-person care or a hybrid telehealth model, those
patients will likely ditch telehealth in favor of going back to the doctor’s
office.
“Prior to the pandemic, patients frequently were reluctant
to use telehealth because it often meant seeing a provider other than their own
physician,” RAND said in its press release. “According to researchers,
sustaining the ability to see one's own doctor through telehealth may be
critical to making telehealth a permanent part of routine health care.”
This suggests a need for two separate strategies going
forward to improve telehealth adoption.
One would focus on convincing patients that virtual care
isn’t a replacement for in-person care with one’s primary care provider, but
can be used to reduce wasteful expenses – for both patient and doctor – and even
improve the level of care.
The second strategy would focus on proving that
direct-to-consumer telehealth platforms that put the patient in front of an
available care provider – not one’s own PCP – are valuable to improving timely
access to care, particularly for episodic care. For someone accustomed to
seeing a particular doctor, a telehealth visit with another provider could be
more appropriate for a quick, one-time care concern, especially if one’s PCP is
busy and a scheduled appointment may take days or weeks.
Among other highlights of the study, researchers found that
the use of synchronous (audio-visual) telemedicine jumped to 11 percent as the
pandemic gained steam between March and May of 2020; in contrast, less than 4
percent were using an audio-visual platform during that same time period the
year before. And of those using video, 30 percent were seeking behavioral
health services and 14 percent were seeking physical health care.
Researchers credited emergency measures enacted during the
coronavirus for compelling providers to use telehealth.
“This shift to telehealth, particularly video, was enabled
by time-limited, regulatory changes related to reimbursement, privacy standards
for telehealth technology, and licensure,” the study reported. “Post-COVID-19
policies will determine whether telehealth remains central to US health care or
returns to the periphery. Decisions should be informed by information about how
patients used telehealth during the crisis.”
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