A study published this month in JMIR Human Factors from Syracuse University researchers found that physicians are in favor of expanding telehealth permanently.  

However, many docs also voiced concerns with limitations of current telehealth technology offerings, noting that market concentration could lead to weighted effects of select platforms' capabilities.   

"As consumers, we want competition which reduces the price and increases the quality," said lead author Bhavneet Walia, assistant professor of public health at Syracuse, about the study.   

"On one hand, from this survey, I believe telehealth can increase access," she said. "On the other hand, as a health economist, I worry that market concentration will reduce access."  

WHY IT MATTERS  

It's clear – at least from the magnitude of appointments over the past year or so – that patients like telehealth.   

But until recently less attention has been paid to clinicians' feelings on the effectiveness and longevity of virtual care.  

Walia's team found that more than 40% of internal medicine physicians say they plan to continue telehealth practices after the pandemic.   

"In the U.S. we talk about this iron triangle of healthcare, which is quality, access, and cost," said Walia.  

"The results of this survey show that physicians who practice internal medicine are in favor. More than 40% say they would continue with telehealth," she added. "This is great in terms of achieving the iron triangle."  

Physicians also said their access to telehealth training increased during the pandemic, suggesting an abrupt shift in healthcare system needs and delivery modes with the onset of the crisis.  

Patient-care visits conducted via telehealth also rose from 13.1% on average before the pandemic to nearly 60% during the early pandemic period.   

Clinicians also felt that telehealth patient visits and face-to-face ones are comparable in quality.  

At the same time, there are hurdles. According to survey respondents, the five most major challenges faced while providing telehealth during the COVID-19 pandemic are:  

1. Limitations on the physician’s ability to deliver certain types of healthcare because of the nature of virtual care.
2. Inadequate telehealth technology.
3. Lack of organizational support for telehealth.
4. Inadequacies in reimbursement for visit.
5. Prior inadequate physician telehealth training.

Given those issues, the most common policy recommendations regarding improvement were:  

1. Malpractice protection for telehealth.
2. Clarity regarding reimbursement policies.
3. Training to use technology more efficiently.
4. Policies regarding duration per episode of care.

Walia also flagged concerns with the possibility of a market dominated by a small number of companies.  

"The goal of advancing telehealth is to increase access, and market concentration can make things work backward. We cannot ignore this if this is going to be the next big thing," said Walia. "Let’s make sure, as policymakers, that we don’t allow market concentration to happen."  

THE LARGER TREND  

Although the telehealth market has been historically dominated by a few major companies, the increase in uptake during the pandemic has opened the door for a flood of newcomers, particularly companies focused on app-based services.

For instance, Amazon announced recently that it would make its phone-centric care available in all 50 states – and specialty prescription apps are also trying to get in on the action.

ON THE RECORD  

"I was surprised by the results," said Walia. "I initially thought that, because of the challenges of telehealth, physicians would not be in favor of continuing post-pandemic. It turns out they do. But make no mistake, there are challenges."

Kat Jercich is senior editor of Healthcare IT News.
Twitter: @kjercich
Email: kjercich@himss.org
Healthcare IT News is a HIMSS Media publication.