COVID-19 accelerated telehealth adoption. That may have unintended consequences.
Posted October 12, 2022
Consumer research firm J.D. Power has released its 2022 U.S. Telehealth Satisfaction Study. The analysis revealed several key trends in Americans' growing usage of telehealth.
For one, 67 percent of study participants had used telehealth in the past year. In comparison, only 37 percent of study participants had utilized telehealth in 2019, before the start of the pandemic. Furthermore, among those who received telehealth services, 94 percent stated that they would "definitely" or "probably" use telehealth in the future. Around 61 percent of those surveyed indicated that the primary reason for using telehealth was convenience, quick service, and easier access to health information.
The extenuating circumstances created by COVID-19 have hastened the pace of telehealth adoption, and the trend is likely to continue. This past July, the U.S. House of Representatives passed a Medicare bill that continues the practice of reimbursing health practitioners for telehealth services. This policy change was made during the pandemic to promote social distancing by decreasing the number of in-person clinic visits. The bill also continues to allow Medicare beneficiaries to receive health services at any location, including their workplace, car, or home. Without these extensions, healthcare providers would be forced to see their Medicare patients in an approved clinical setting. Many people lauded the bill, which passed with bipartisan support.
As a patient, I have had many positive experiences with telehealth. Before the pandemic, I used to ignore well-meaning check-up reminders because I simply couldn't find the time to go to an appointment. I even saw a few physicians diagnose themselves and prescribe their own medications because they didn't want to cancel their clinic schedule in order to see a doctor for their own condition. After the start of COVID-19, I finally had an opportunity to go to a doctor's appointment without leaving work, thanks to the convenience of telehealth. I saw more healthcare providers in the second and third years of the pandemic than I had in previous years.
When one of my long-term telehealth providers offered the option of coming into his office for a follow-up appointment, I realized that I had gotten used to receiving care in the comfort of my office or home. I didn't want to go through the small inconveniences of walking to the office, signing in with a receptionist, and waiting in unfamiliar chairs to be called in. I politely declined the offer.
Although I love telehealth as a patient, from the perspective of a practicing physician, I am a little more ambivalent. Most physicians, including me, did not receive formal training on telehealth in medical school, so many of us had to learn and adapt our practice on the fly. There are currently no widely agreed-upon standards for conducting telehealth visits. Furthermore, there are many things that I can't do in a telehealth visit that I could easily do in an in-person visit, such as conducting physical exams, performing small in-office procedures, or running a bedside diagnostic test.
When a patient describes a new problem through a message, phone call, or video chat, I worry that something may be lost in translation or that I may miss an important detail. If the problem has even the smallest potential of causing lasting harm, I ask the patients to come to the clinic so that I can take a closer look. More than once, I had to change my initial understanding of the problem upon seeing them in the exam room.
Of course, the challenges with telehealth will largely depend on the specialty. It's very likely that less physically-oriented specialties—like psychology or psychiatry—may work better in a telehealth format. For example, in the J.D. Power research mentioned above, 57 percent of people said they would prefer virtual visits to in-office visits for mental health visits.
Ultimately, COVID-19 forced us to open Pandora's box of telehealth, and it is here to stay. There will undoubtedly be some hiccups along the way, including misdiagnoses leading to delayed care. However, we should weigh these potential pitfalls against the fact that telehealth will allow patients to access their providers more easily. Looking toward the future, patients should be aware that some key details may be lost through the phone or the screen, and healthcare providers should work to develop evidence-based best practice guidelines to optimize telehealth visits.
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