Consumer Survey
Telemedicine has changed all our lives given the pandemic, but are consumers and physicians embracing the change? A recent survey, by Doximity, examined patient perspectives and physician adoption since COVID-19.
Prior to the pandemic, telemedicine was limited to those who lived in rural areas and at a specific site or location for a patient. The Centers for Medicare and Medicaid Services (CMS), relaxed the rules during the pandemic for telemedicine and the health insurance companies (payers) followed. This allowed patients to abide by shelter-in-place orders and physicians to provide ongoing care to their patients.
Physician and patient adoption rose because of: flexibility, ease-of-use, and technology allowing for video or face time options if a patient wanted to engage face-to-face with a physician.
Will the relaxed rules of telemedicine continue in 2021? This is being evaluated but will likely be an option as patients and physicians continue to adopt. This will be a significant change in how health care is delivered.
Before COVID-19: Patient Insights
Source: Doximity: 2020 State of Telemedicine Report
As mentioned telemedicine was limited and while most Americans had heard of Telemedicine, most preferred the traditional office visit. Providers were slowly adopting Telemedicine, mostly larger medical practices, but given the limitations of CMS rules there were more questions about reimbursement and patient adoption, and was it worth it to pursue Telemedicine adoption.
During COVID-19: Patient Insights
During COVID-19, 55 % of patients have delayed or avoided medical care. Source: Health Care Innovation: Patients Delayed Care. Reasons for this may be attributed to a lack of being uncomfortable with Telemedicine options or concerns with health care offices and facilities as virus hotspots and not worth the risk. Types of care avoided were family medicine followed by allergy, dermatology and audiology. The concern of delayed care is patients not following up on preventative care such as skin checks, monitoring blood pressure or glucose check ins. In addition, physicians have experienced a significant drop in their revenue in some cases 40%-60% due to patients opting to delay care.
In other cases, many Americans have adopted Telemedicine for general care and chronic illness. According to the Doximity survey, Telemedicine adoption has increased by 57% for general care and 77% for chronic illness. Patients also seem to be pleased with the process, opting to continue using Telemedicine once the pandemic ends.
Source: Doximity: 2020 State of Telemedicine Report
Quality of Care – Telemedicine
Telemedicine offers patients lower costs, convenience, safer options to limit infection and improved access to care. For physicians it offers a reduction in overhead expenses, additional revenue streams, less exposure to illness and infections and the opportunity to still care for their patients. Source: Medical News Today: Telemedicine Benefits, Patients and Professionals.
All benefits considered, there are disadvantages in that Telemedicine may not be perceived as an option for every patient. There are limits due to access to technology and a level of comfort in using technology for the Baby Boomer population.
Depending on the technology option used, phone or video, patients may find it more difficult to describe their condition over the phone or share with the provider a skin concern over video.
That said, 23% of Americans felt comfortable with Telemedicine options and that they received the same or better quality care from their provider.
Source: Doximity: 2020 State of Telemedicine Report
Access to Care – Telemedicine Options
While COVID-19 has forced people to work from home and invest in new technology to support work requirements, not everyone can purchase equipment needed for Telemedicine options or afford broadband. This brings up the awareness related to health care equity for all.
Pre COVID-19 in order to use Telemedicine high-speed internet was mandatory, but with the stiff requirements lifted by CMS, this has allowed multiple options for patients to seek care. This also allowed for physicians to provide care to their patients without an upfront expense in video cameras and secure application platforms to provide care.
The access to care is now available for most, but there are still limits to US adults.
Source: Doximity: 2020 State of Telemedicine Report
Telemedicine Adoption By Physicians and State
Physicians have embraced Telemedicine options, in fact most have COVID-19 pop ups on their websites stating their updates and requirements for care and entering their facility. Patients will also find options for scheduling a Telehealth visit and in some cases information on what to expect.
The Doximity reports that adoption by physicians are occurring more in larger metro areas with the top 3 states with the highest adoption rates: Massachusetts, North Carolina and New Jersey. The top cities are known for their major health care facilities with national leadership recognized in health care innovation.
In viewing the top 10 states, the leading adoption rate is occurring in the Eastern side of the US.
Source: Doximity: 2020 State of Telemedicine Report
Summary Telemedicine
Telemedicine care once avoided is becoming more widely accepted as an efficient, safe and cost effective mode of health care delivery. With no end in sight for the pandemic, there is the continued fear of infection coupled with no vaccine. Patients need to have options to get care versus avoiding or delaying care.
For patients the convenience and renewed confidence in quality of care will only promote demand and increased usage.
For physicians, the adoption rate has increased, providing essential options to provide care during the pandemic. While Telemedicine is being embraced, the question on the table remains if CMS will continue to allow for the flexibility and continued use once the pandemic is over. In addition, physicians have had to adjust to all the Telemedicine changes, which may differ from payer to payer causing administrative burden. If extended, CMS and payers will need to define ways to ease the administrative pain points for the physicians so they can focus care on the patient.
All said, COVID-19 has launched Telemedicine providing needed options for both patients and physicians, with the longer term forecast of Telemedicine being here to stay and expand in 2021.