Telehealth continues to support continuity of care and to increase access to and willingness to use the health care system, according to survey authors.
Patients with chronic conditions were 88% more likely to adopt telehealth than those without persistent disease in 2022 and continue to be 56% more likely to use it in 2022, according to a survey of 2000 US adults conducted by aetnahealth between January 2019 and April 2, 2022.
Persons with chronic conditions reported that they used telehealth visits to manage their conditions both in place of what would have otherwise been regular in-person visits (23%) as well as for ad-hoc between-visit check ins (9%) to address acute concerns. These findings, among others from the survey, released September 28, 2022, suggest that telehealth, adopted rapidly in early 2020 to reduce face-to-face interactions as the COVID-19 pandemic surged, is serving an unmet health care need, allowing patients to access care they want without the need to be seen in person.
“Our research brings to light the vital role telehealth can play in patient care,” said Jessica Sweeney-Platt, vice president of research and editorial strategy at aetnahealth in a company announcement. “Not only does it increase access to care, but it can drive better patient outcomes when used as an extension of in-person visits to provide continuity of care.”
Virtual health care visits in the spring of 2020 accounted for approximately 12.1% of all visits, according to the survey. And even though there has been a gradual but steady return to in-person care as COVID cases have dropped and precautions have lessened, virtual care still accounted for 8.9% of all care in the first half of 2022. It could be a sign that the remote option is now considered a reliable mode of treatment delivery, said survey authors, pointing out that prior to the COVID-19 pandemic, telehealth accounted for only 0.4% of all health care visits.
The survey found that 24% of respondents used telehealth because they felt their health concern did not warrant an in-person visit, a choice that potentially reduces clinic workload. It is also another indication that the telehealth option may become a tool for more frequent contact with the health care system, including for preventive care, study authors write.
Results from this survey support other emerging data on use of telehealth for mental health care with 25% of respondents saying they attended a telehealth visit to address a new mental health concern during the survey period and 23% indicating they are more likely to seek out mental health support because a telehealth option is available. Further, the survey revealed that nearly 2 times more new mental health diagnoses were made during telehealth visits vs in-person visits. Sweeney-Platt notes that telehealth may be increasing the ability to engage with mental health services and, perhaps more importantly, the willingness to do so.
The research findings exposed significant gender differences in both use and offering of telehealth services: In 2021, male health care professionals were 24% less likely to provide a telehealth visit than female clinicians and the disparity increased over time, according to the survey. Among patients, use of telehealth by men was 15% lower than among women. Moreover, after adjusting for a range of patient characteristics, health care professional gender affected patient uptake of telehealth, ie, patients who worked with a single male clinician had 60% lower odds of adopting telehealth compared with those seeing only a female provider.
Patterns of telehealth use also varied by race, according to survey results which found that although Black and Hispanic patients are more likely to use the remote service overall, they are less likely to use telehealth to engage consistently with a single clinician or care team. The data suggest that racial and ethnic minority patients are more likely to use telehealth episodically, being seen by any available clinician vs one with whom they have an ongoing relationship.
Sweeney-Platt noted that the data provide a “very surprising and nuanced picture of how telehealth is addressing racial health equity.”
“Based on our findings, we hypothesize that some patient populations who typically lean on in-person urgent care and ED settings are benefiting from the convenience of telehealth,” said Allison Roberts, PhD, MPH, athenahealth’s quantitative research manager, in an article addressing the survey findings. “However, when applied equitably, telehealth presents an opportunity to improve care coordination, provide more stable access to affordable care, and allow care teams to better collaborate.
“There’s a version of virtual care where patients and providers are more connected, better informed, and experience fewer barriers. That version is being modeled in some communities, but not all just yet.”