Telehealth use jumps at inpatient facilities while outpatient adoption remains flat: survey

Telehealth adoption among hospitals and health systems is on the rise—up from 54% in 2014 to 85% in 2019—while adoption among outpatient healthcare facilities remains flat, according to two new reports.

Almost two-thirds of hospitals, health systems and academic medical centers (70%) are using two-way video/webcam technology specifically between physicians and patients, up from 47% in 2016, according to Definitive Healthcare's fifth annual inpatient telehealth study based on responses from 175 C-suite leaders, directors/vice presidents of IT and department directors at inpatient facilities.

Health systems and hospitals also are increasingly using population management tools such as SMS text, with adoption of those tools growing from 12% in 2016 to 19% in 2019. Remote patient monitoring through clinical-grade devices also grew but at a slower pace, up from 8% three years ago to 14% in 2019.

Nearly a quarter of inpatient facilities (23%) are using mobile applications for concierge services, up from 17% in 2016.

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At the same time, patient portal usage has dropped for the first time in four years from sitting between 47% and 49% to 40% in 2019, according to the survey. Other technologies coming to market have begun to replace some of the core functionality once delivered through the portal or application-focused patient engagement efforts.

Hospitals and health systems plan to ramp up investment in telehealth technologies as 90% of organizations looking to make future investments in telehealth services plan to do so in the next 18 months. 

Less than 10% of organizations have constructed a dedicated telehealth or virtual care center, but another 10% are in the process of constructing a telehealth facility or have plans to build one.

"There remain some complexities around the market for telehealth including physician reimbursement and liability, patient access, and cost of implementing these services. But as adoption has increased and the telehealth market has matured, organizations have a better sense of overcoming some of these hurdles and directly impacting patient care," the report authors said.

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"With healthcare moving from fee for service to value-based care and with the increased focus on population health, patient engagement and more personalized care delivery, telehealth solutions and services can help bridge numerous gaps that exist in the current healthcare landscape,” Jason Krantz, CEO of Definitive Healthcare, said in a statement.

Ongoing challenges for outpatient telehealth adoption 

The adoption of telehealth tools continues to show signs of challenges in the outpatient setting as overall adoption growth remained relatively unchanged from 2018 to 2019 at about 44%, according to Definitive Healthcare's outpatient telehealth report based on a survey of 270 physicians and administrators at outpatient facilities.

There also continues to be a divide between hospital-owned and nonhospital-owned practices as roughly 55% of hospital-owned practices have adopted telehealth versus just 37% for nonhospital-owned practices.

Consumer demand for telehealth services has become a stronger catalyst for physician practices to adopt telehealth compared to previous surveys. This could help to drive continued adoption, but it may take some time before patients become comfortable with telehealth versus in-office visits, the report said.

Among physician practices, health clinics and ambulatory surgery centers, the use of two-way video/webcam technology between the physician and patient grew from 45% in 2018 to 68% in 2019. More care is being driven to outpatient settings to help manage immediate care needs and to reduce care costs, the report said.

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There were also increases in the use of mobile applications for things such as e-visits or virtual visits and remote patient monitoring via consumer devices.

About 13% of practice leaders cited uncertainty surrounding reimbursement policies from insurance companies and at the national level as a barrier to adopting telehealth solutions.

In April, the Center for Medicare & Medicaid Services finalized policies that would allow Medicare beneficiaries to receive access to telehealth services from their home rather than a healthcare facility, and that could help drive more interest in telehealth tools.

Krantz identified three main hurdles standing in the way of practice leaders more rapidly adopting telehealth.

"There is not only a need for more clarity around reimbursement policies but also a need for more interoperable telehealth solutions that can be accessed through EHR (electronic health record) or EMR (electronic medical record) systems as well as a better understanding about what types of telehealth options are available,” he said.

“Until some of these issues are addressed, it may be some time before substantial outpatient investment is made in the telehealth arena," Krantz said.