In rush to embrace telehealth, many physicians still have concerns about quality of care, survey finds

Telehealth consultation
Some industry leaders urge policymakers to do more research on the impact of telehealth to address ongoing concerns about care quality and to evaluate barriers to virtual care. (Getty/AndreyPopov)

During the height of the COVID-19 pandemic, doctors turned to virtual consultations to continue to provide care to their patients.

But close to 60% of physicians have lingering reservations about the quality of care they can provide remotely, according to a recent survey.

Four out of five physicians used telehealth during the pandemic, according to Decision Resources Groups' two-part survey of 4,855 practicing U.S. physicians conducted in March and April, with a follow-up survey in July.

As of July 2020, 80% of U.S. physicians had conducted a virtual patient consultation in the previous three months—up from 39% in April and 9% in early March, when use of virtual consults was unchanged over 2019 levels.

But, among the 20% of physicians who did not use telehealth during the past three months, the top reason cited was the possibility of diminished quality of care (49%).

RELATED: Trump signs executive order to expand telehealth, boost rural health care

Those physicians also cited liability risks (44%) and concerns about privacy/data security (29%) as reasons why they did not offer virtual consultations. Some practices do not offer virtual consultations, according to 29% of those physicians. Doctors also were concerned about reimbursement (21%) or said telehealth was not relevant to their specialty (21%).

Among those physicians surveyed in June and July who said they had conducted virtual consultations in the past three months, about half (52%) said they will likely continue to do so after COVID-19 mitigation measures have ended.

The urgency of COVID-19 mitigation has greatly accelerated telemedicine adoption in a way that will have a lasting impact on care delivery, according to Matthew Arnold, principal analyst at Decision Resources Group, part of Clarivate.

"U.S. physicians are seeing patients remotely as often as they are in person, and many are getting comfortable with a modality of care that is less office-bound and episodic," Arnold said in a statement.

RELATED: Half of physicians now using telehealth as COVID-19 changes practice operations

President Donald Trump issued an executive order in August to support healthcare in rural areas by permanently expanding some telehealth services beyond the COVID-19 pandemic.

Centers for Medicare and Medicaid Services (CMS) officials also issued a proposed Physician Fee Schedule rule that will cement some regulatory flexibilities enacted during the public health emergency to reimburse for telehealth visits.

However, in discussions during recent virtual panels and even Congressional hearings, many industry leaders say there needs to be more research on the impact of telehealth to address ongoing concerns about care quality and to evaluate potential barriers for underserved populations.

In a recent Health Affairs blog, Lori Uscher-Pines, a senior policy researcher at the nonprofit, nonpartisan RAND Corporation, wrote that many providers said they transitioned to telehealth in March 2020 "not because they were convinced of its value, but because they had to out of desperation."

"Some physicians also expressed concerns over the quality of telehealth visits, such as an inability to conduct a physical exam. Furthermore, for providers too many things may have changed at once, making it difficult for them to assess the independent impact of telehealth on quality of care," Uscher-Pines wrote, noting that many providers are now going back to in-person visits.

Policymakers need to signal their intentions sooner rather than later regarding payment policy to reduce uncertainty and encourage investment in sustainable telehealth models, she wrote.

"Without permanent policy changes, it is unclear if telehealth services will represent a significant proportion of U.S. health care visits in the long run," she said.

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