Association of Telehealth with Short-Interval Follow-Up

Chavez, Augustine; Pullins, Christopher; Yennie, Julia; Singh, Charanjit; Kosiorek, Heidi E.

doi:10.3122/jabfm.2022.03.210520

Cited by 6 publications

(10 citation statements)

References 0 publications

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“…The 30 studies included 14 (47%) retrospective cohorts [ 30 - 43 ], 6 (20%) cross-sectional studies [ 44 - 49 ], 4 (13%) quasi-experimental studies [ 29 , 50 - 52 ], 3 (10%) randomized controlled trials (RCTs) [ 53 - 55 ], 2 (7%) cohort studies [ 56 , 57 ], and 1 (3%) cluster RCT [ 58 ]. Most studies were conducted in the United States (20/30, 67%) [ 30 - 34 , 36 - 44 , 46 - 49 , 53 , 58 ], whereas the rest were conducted in Australia (2/30, 7%) [ 35 , 45 ], Canada (2/30, 7%) [ 50 , 52 ], Kenya (1/30, 3%) [ 54 ], the United Kingdom (1/30, 3%) [ 51 ], Japan (1/30, 3%) [ 55 ], Singapore (1/30, 3%) [ 29 ], New Zealand (1/30, 3%) [ 56 ], and Sweden (1/30, 3%) [ 57 ].…”

Section: Resultsmentioning

confidence: 99%

“…Of these 16 studies, 11 (69%) found a positive impact (n=6, 55%) or no impact (n=5, 45%) on efficiency in at least half of the outcomes extracted [ 29 , 32 , 36 , 37 , 41 , 43 - 45 , 50 , 51 , 53 ]. Of the 8 studies comparing rates of follow-up visits in primary care, 5 (63%) found that virtual consultations resulted in a greater need for additional care [ 33 , 34 , 41 , 44 , 56 ], whereas 3 (38%) found no differences [ 37 , 50 , 51 ].…”

Section: Resultsmentioning

confidence: 99%

“…This negative impact on efficiency may to some extent be explained by the time frames during which the studies were conducted. In those occurring shortly after the onset of the pandemic [ 34 , 56 ], when the rapid transition to virtual care was necessary, the increased rate of follow-up may be a consequence of lower clinician or patient confidence in virtual care owing to its initial unfamiliarity [ 37 ].…”

Section: Discussionmentioning

confidence: 99%

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The Impact of Virtual Consultations on the Quality of Primary Care: Systematic Review

Campbell,

Greenfield,

et al. 2023

J Med Internet Res

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Background The adoption of virtual consultations, catalyzed by the COVID-19 pandemic, has transformed the delivery of primary care services. Owing to their rapid global proliferation, there is a need to comprehensively evaluate the impact of virtual consultations on all aspects of care quality. Objective This study aims to evaluate the impact of virtual consultations on the quality of primary care. Methods A total of 6 databases were searched. Studies that evaluated the impact of virtual consultations, for any disease, were included. Title and abstract screening and full-text screening were performed by 2 pairs of investigators. Risk of bias was assessed using the Mixed Methods Appraisal Tool. A narrative synthesis of the results was performed. Results In total, 30 studies (5,469,333 participants) were included in this review. Our findings suggest that virtual consultations are equally effective to or more effective than face-to-face care for the management of certain conditions, including mental illness, excessive smoking, and alcohol consumption. Overall, 4 studies indicated positive impacts on some aspects of patient-centeredness; however, a negative impact was noted on patients’ perceived autonomy support (ie, the degree to which people perceive those in positions of authority to be autonomy supportive). Virtual consultations may reduce waiting times, lower patient costs, and reduce rates of follow-up in secondary and tertiary care settings. Evidence for the impact on clinical safety is extremely limited. Evidence regarding equity was considerably mixed. Overall, it appears that virtual care is more likely to be used by younger, female patients, with disparities among other subgroups depending on contextual factors. Conclusions Our systematic review demonstrated that virtual consultations may be as effective as face-to-face care and have a potentially positive impact on the efficiency and timeliness of care; however, there is a considerable lack of evidence on the impacts on patient safety, equity, and patient-centeredness, highlighting areas where future research efforts should be devoted. Capitalizing on real-world data, as well as clinical trials, is crucial to ensure that the use of virtual consultations is tailored according to patient needs and is inclusive of the intended end users. Data collection methods that are bespoke to the primary care context and account for patient characteristics are necessary to generate a stronger evidence base to inform future virtual care policies.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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The Impact of Virtual Consultations on the Quality of Primary Care: Systematic Review

Campbell,

Greenfield,

et al. 2023

J Med Internet Res

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“…They most used telemedicine visits for administrative needs, minor medical conditions, and convenience (11,10). It was also found that, compared with FTF visits, telemedicine visits were associated with signi cantly higher rates of total short-interval follow-ups every 0 to 15 days (12). These ndings reinforce the concern that adding telemedicine visits will not replace FTF visits but will add to them.…”

mentioning

confidence: 79%

The impact of telemedicine on physician time invested in primary care- A large population-based descriptive study

Golan‐Cohen

Vinker

Merzon

et al. 2023

Preprint

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Background: Telemedicine, including video visits, telephone visits, and digital correspondence, is increasingly offered by physicians, particularly since the Covid-19 pandemic. It is still unclear whether increasing the variety of services creates an increase in demand and therefore causes an increase in the workload of primary care physicians (PCPs). In this study, we used Accumulated Annual Duration of Time (AADT), an accepted index for assessing the workload of PCPs, to evaluate the impact of telemedicine on demands. Methods: A population-based descriptive study among 464,119 patients who were not diagnosed with Covid-19 and were members of Leumit Health Services, a prominent Israeli health fund, during the 2020-2021 study period. The patients were divided into three groups according to the characteristics of their visits in 2020 and 2021. A comparison of the average AADT in each period considering the changes in the visit types was made. Results: Telemedicine use was higher in older persons, females, those of higher socioeconomic status, and patients with comorbidities. The greater the number of telemedicine visits, the greater the time the PCP spent on visits during the year. The largest increase in AADT (56.1%) was observed in patients who had only face-to-face meetings in 2020 but in 2021 made all types of visits. Overall, there was an increase of 2.5% in time invested in 2021 and a 5.8% increase in the number of patients making digital visits. Conclusions: Policymakers encouraging telemedicine should consider the additional load on PCPs associated with telemedicine use and plan resources accordingly.

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“…Of these 16 studies, 11 (69%) found a positive impact (n=6, 55%) or no impact (n=5, 45%) on efficiency in at least half of the outcomes extracted [29,32,36,37,41,[43][44][45]50,51,53]. Of the 8 studies comparing rates of follow-up visits in primary care, 5 (63%) found that virtual consultations resulted in a greater need for additional care [33,34,41,44,56], whereas 3 (38%) found no differences [37,50,51].…”

Section: Efficiencymentioning

confidence: 99%

The Impact of Virtual Consultations on the Quality of Primary Care: Systematic Review (Preprint)

Campbell,

Greenfield,

et al. 2023

Preprint

View full text Add to dashboard Cite

BACKGROUND The adoption of virtual consultations, catalyzed by the COVID-19 pandemic, has transformed the delivery of primary care services. Owing to their rapid global proliferation, there is a need to comprehensively evaluate the impact of virtual consultations on all aspects of care quality. OBJECTIVE This study aims to evaluate the impact of virtual consultations on the quality of primary care. METHODS A total of 6 databases were searched. Studies that evaluated the impact of virtual consultations, for any disease, were included. Title and abstract screening and full-text screening were performed by 2 pairs of investigators. Risk of bias was assessed using the Mixed Methods Appraisal Tool. A narrative synthesis of the results was performed. RESULTS In total, 30 studies (5,469,333 participants) were included in this review. Our findings suggest that virtual consultations are equally effective to or more effective than face-to-face care for the management of certain conditions, including mental illness, excessive smoking, and alcohol consumption. Overall, 4 studies indicated positive impacts on some aspects of patient-centeredness; however, a negative impact was noted on patients’ perceived autonomy support (ie, the degree to which people perceive those in positions of authority to be autonomy supportive). Virtual consultations may reduce waiting times, lower patient costs, and reduce rates of follow-up in secondary and tertiary care settings. Evidence for the impact on clinical safety is extremely limited. Evidence regarding equity was considerably mixed. Overall, it appears that virtual care is more likely to be used by younger, female patients, with disparities among other subgroups depending on contextual factors. CONCLUSIONS Our systematic review demonstrated that virtual consultations may be as effective as face-to-face care and have a potentially positive impact on the efficiency and timeliness of care; however, there is a considerable lack of evidence on the impacts on patient safety, equity, and patient-centeredness, highlighting areas where future research efforts should be devoted. Capitalizing on real-world data, as well as clinical trials, is crucial to ensure that the use of virtual consultations is tailored according to patient needs and is inclusive of the intended end users. Data collection methods that are bespoke to the primary care context and account for patient characteristics are necessary to generate a stronger evidence base to inform future virtual care policies. CLINICALTRIAL

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Association of Telehealth with Short-Interval Follow-Up

Cited by 6 publications

References 0 publications

The Impact of Virtual Consultations on the Quality of Primary Care: Systematic Review

The Impact of Virtual Consultations on the Quality of Primary Care: Systematic Review

The impact of telemedicine on physician time invested in primary care- A large population-based descriptive study

The Impact of Virtual Consultations on the Quality of Primary Care: Systematic Review (Preprint)

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