A study published this past week in JAMA Network Open found that while the vast majority of physicians in a large regional healthcare system had transitioned to include virtual care in their practice by December 2020, some were more likely to be early adopters than others.  

Researchers from Massachusetts General Hospital retrospectively analyzed data from all 3,473 physicians providing ambulatory care through Mass General Brigham, which includes 12 hospitals.

"Some physicians may have been nimbler than others in making the transition [to telehealth], potentially influencing patients' experience of physician access and availability," wrote the research team.  

WHY IT MATTERS  

The research team notes that despite an assumption that a COVID-19-fueled shift to virtual care happened "all at once," that may not have always been the case – potentially leading to some patients who didn't feel safe seeking in-person care being left behind.  

To analyze which physicians made the transition sooner, the researchers used Epic electronic health record data to analyze visits between Oct. 1, 2019, and Dec. 31, 2020.  

"Similar to many large academic health systems, the transition to virtual care in our system was scaled up rapidly at the time of the public health emergency declaration" on March 15, 2020, read the study.  

The researchers organized physicians into four categories:   

• Innovators (those with virtual visits before March 15, 2020).
• Early adopters (those who adopted telehealth during the week of March 15).
• Majority (those adopting March 22, 2020, or later).
• Persistent non-adopters (no adoption through Dec. 31, 2020).  

Of the 3,473 physicians, 13.8% were innovators, 45.0% were early adopters, 35.6% were in "the majority" and 5.6% were persistent non-adopters.  

Younger generations had larger proportions of innovators and early adopters, as did behavioral health and primary care physicians.   

Innovators and early adopters were also more often female, while physicians in surgical specialties and those born between 1928 and 1945 (also known as the Silent Generation) were less likely to be early adopters.  

"Interestingly, we found slightly increased odds of early adoption with [an] increasing percentage of patients who preferred speaking a language other than English but slightly decreased odds of early adoption with increasing percentage of patients from a racial or ethnic minority group," read the study.

"Further work examining the interaction between physicians' patient panels and adoption of virtual healthcare will be critical to ensure equitable access to care across patient groups," noted the researchers.  

THE LARGER TREND  

Although the initial spike in telehealth usage has certainly leveled off, many physicians say they're in favor of permanent virtual care expansion, with primary care being one potential focus of future innovation.

At the same time, however, they stress the importance of policy changes to help overcome existing challenges, including reimbursement clarity and training to use technology more efficiently.  

ON THE RECORD  

"Although we did not collect data to explore why some physicians did or did not adopt virtual healthcare, there are several plausible explanations," read the JAMA Network Open study. 

"For example, the toll of the pandemic on women in caregiving roles has been well described, and this group may have found that virtual care provided a flexible solution that enabled them to balance or maintain their many roles," it continued.

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