While telehealth alone doesn't appear to add significantly to a primary care physician's workload, mixing modalities – telehealth and in-person hybrid care environments – led to a 6% increase in time spent with documentary and EHR work, new research shows.

WHY IT MATTERS
These were among the results of an April study by MedStar Health Research Institute and Georgetown University School of Medicine published in JAMA Network Open, which focused on how hybrid-care environments impact the administrative duties of PCPs.  

The research team examined the percentage of daily visits via telehealth across five levels, and analyzed various measures of active EHR time for PCPs for 67,894 days.

Days with both telehealth and in-person care correlated with increased EHR, documentation, and medical-record review time.

Days with 26% to 99% of visits via telehealth were associated with nearly 15 minutes more of active EHR time, around five additional documentation minutes and 5.5 more medical record review minutes.

However, hybrid care showed no impact on next-day documentation time, suggesting PCPs managed to integrate the additional workload.

"Greater EHR time may be due to increased multitasking during telemedicine visits, as PCPs simultaneously engage with patients and the EHR during telemedicine visits in ways that are not possible in person," the report noted. "This multitasking may feel more efficient and therefore may not register as 'burdensome.'"

The report authors recommended further research be conducted to more closely determine whether additional EHR time on days with mixed modality care were a burden to physicians.

THE LARGER TREND
A recent Health Affairs report demonstrates telehealth improves outcomes and reduces spending, revealing increased medication adherence and decreased hospitalizations and ER visits, but the future of regulatory flexibilities came under scrutiny.

The technology could also help providers improve healthcare equity and access to care, though a detailed implementation strategy will be required for those aims to be reached.

Potential benefits also extend to telepsychiatry, particularly to help reach patients in rural areas where there is a lack of specialists, according to a peer-reviewed research report on the topic.

Care providers are looking at integrating AI with telemedicine services to improve patient care as some experts argue telehealth technology can bring benefits to providers and patients in the area of primary care.

Cedars-Sinai recently expanded its AI-powered virtual healthcare platform, Cedars-Sinai Connect, to include a Spanish version catering to parents of children aged 3 to 17, offering 24/7 on-demand access to healthcare providers for urgent issues.

The evolution to telehealth is not without speed bumps and setbacks, however, as demonstrated most recently by Walmart's decision to end its virtual care program in the face of rising operating costs and a "challenging reimbursement environment," while Optum Care is also shuttering its large telehealth business.

ON THE RECORD
"Telemedicine use increased substantially during and after the COVID-19 pandemic and has the potential to provide low-acuity medical services at lower costs," wrote MedStar and Georgetown researchers.

"However, telemedicine also levies new costs on clinicians. Telemedicine requires shifting care delivery workflows, as it rarely includes clinical support staff but can involve levels of patient complexity similar to in-person visits. This may increase administrative and electronic health record burden for clinicians and increase cognitive costs as clinicians switch modalities."