A study of 40.7 million commercially insured adults in the United States who sought care via telehealth found contrasting patterns of follow-up care between those with chronic conditions and those with acute clinical conditions.   

The research, which was published this week in JAMA Network Open, assessed outcomes of care two weeks after patients' initial ambulatory encounters.  

"Telehealth accounted for a large share of ambulatory encounters at the peak of the pandemic and remained prevalent after infection rates subsided," said researchers in the study, which was funded in part by the American Telemedicine Association.  

"Telehealth encounters for chronic conditions had similar rates of follow-up to in-person encounters for these conditions, whereas telehealth encounters for acute conditions seemed to be more likely than in-person encounters to require follow-up," they observed.  

WHY IT MATTERS  

The surge of telehealth visits during the COVID-19 pandemic – and the ensuing longevity of the model – has been the subject of extensive inquiry over the past two years. This latest study examined more than 40 million privately insured patients under the age of 65, during the period from July to December 2020.  

"This study appears to be the first published assessment of clinically relevant outcomes comparing telehealth and in-person encounters in a nationally representative population, and one of the most comprehensive telehealth assessments from late 2020, looking at factors associated with changing patterns of telehealth use beyond the initial months of the pandemic,” said Dr. Joe Kvedar, chair of the ATA board, in a statement accompanying the findings.  

Researchers at the Johns Hopkins Bloomberg School of Public Health, along with collaborators from Blue Health Intelligence and the Digital Medicine Society, found that patients with acute clinical conditions who first sought care via telehealth had higher odds of having a follow-up encounter, an emergency department encounter and in-patient admission than those who sought care in person.  

However, for those with chronic conditions, the odds of follow-up encounter were lower for those with an initial telehealth encounter.

"This trend was observed especially for acute respiratory-related conditions, which potentially could be confounded by concerns over COVID-19 rather than the less complicated acute non-COVID-19 diagnosis," wrote researchers.   

THE LARGER TREND

Many previous large studies of telehealth use have relied on Medicare data. Although that is helpful for determining utilization among the Medicare population, of course, some behavioral economists have also emphasized the importance of looking to commercially insured groups for a more complete picture.  

A report from Trilliant Health, for instance, contended that most telehealth users only had one virtual visit from the start of the pandemic through November 2021.  

"It's not to say that virtual care companies won't be successful, but you have to know the bounds of your consumer base," Sanjula Jain, chief research officer at Trilliant, told Healthcare IT News.

ON THE RECORD  

"These findings can help policymakers, payers and healthcare providers better manage the use of telehealth in the months and years ahead," said Kvedar about the JAMA Network Open study.

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