Study: Telehealth can cut down in-person visits in the short term. Its long-term benefits remain murky

Businessman video-chats with doctor on laptop
Can telehealth cut down in-person visits in the long term? The jury is out, researchers say. (Getty/AndreyPopov)

Telemedicine presents a viable way for providers to cut down on unneeded in-person visits and reach patients in more remote areas. 

But their impact over time appears to drop off, raising questions about their long-term benefits, according to a new study. 

Researchers followed Massachusetts General Physicians Organization’s rollout of a telemedicine program under Partners HealthCare’s accountable care organization, tracking data on 35,000 patients from between 2014 and 2017. They found that virtual visits decreased in-person visits by 33% over the course of the first year and a half.

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But the trend didn’t extend beyond that early window, the study found. After about a year, the rate of in-person visits among the patients returned to levels recorded before the virtual visits were offered. 

The telemedicine program also increased total visits by 80% over the first year and a half, according to the study.  

ACOs must be adaptive in how they implement telemedicine programs, including: 
  1. Set clear goals, and measure progress against those goals.
  2. Work with clinicians to ensure that telehealth fits their workflows.
  3. Consider all the elements of value, not just cost and access. Also focus on patient experience and outcomes.
  4. Watch for potential disparities.

Source: Sachin Shah, M.D.

RELATED: Study charts recent spike in telehealth usage, particularly within primary care 

But the results don’t mean that accountable care organizations should write off telehealth and virtual visits entirely, lead study author Sachin Shah, M.D., an assistant professor at the University of California, San Francisco, told FierceHealthcare. Instead, ACOs must be adaptive in how they implement such programs. 

“ACOs have a unique opportunity to implement innovative care models that decrease costs, improve outcomes and improve the patient experience,” Shah said. “There are clearly some office visits that can be done as well, or better, using virtual visits.” 

For example, these programs should be tested in different points of care. While the Mass General physician group didn’t find exceptional results in ambulatory care, Partners’ ACO could benefit from telehealth in other care settings. 

Population-based programs need to be nimble enough to conduct some trial-and-error testing, the researcher said. 

RELATED: Telehealth reimbursement uncertainty creating inequities in healthcare  

Shah said it’s not uncommon for new technology to make disparities worse early on, but the response to those gaps is crucial. 

“The reality is new healthcare technologies almost always widen disparities when first introduced,” he said. “Acknowledging this fact is the first step. The next step is to engage the traditionally marginalized patient and other physicians to identify the factors that result in differential access and test the solution.”

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