Family Physicians Report Considerable Interest in, but Limited Use of, Telehealth Services

Abstract

Purpose:Little is known about the attitudes toward and adoption of telehealth services among family physicians (FPs), the largest primary care physician group. We conducted a national survey of FPs, randomly sampled from membership organization files, to investigate use of and barriers to using telehealth services.Methods: Using bivariate analyses, we examined how telehealth usage affected FPs' identified barriers to using telehealth services. Logistic regressions show the factors associated both with using telehealth services and with barriers to using telehealth services.Results: Surveys reached 4980 FPs; 1557 surveys were eligible for analysis (31% response rate). Among FPs, 15% reported using telehealth services during 2014. After controlling for the characteristics of the physicians and their practice, FPs who were based in a rural setting, worked in a practice owned by an integrated health system or other ownership structure, and provided hospital/urgent/emergency care were more likely to use telehealth. Physician and practice characteristics by telehealth use status, sex of the physician, practice location, years in practice, care provided, and practice ownership were associated with the barriers identified. As health care delivery in the United States transitions to a patient-centered, value-based system with improved access to services, physician availability is a challenge. Telehealth could help address this problem. Although the term telehealth has been widely applied and well recognized for more than 4 decades, it lacks a singular definition. Broadly, telehealth is the use of technology to deliver health care services and information from a distance. Telehealth usage has evolved from static "store-and-forward" applications in which information, such as radiologic images, is stored and then forwarded for diagnostic review or a second opinion. Today's clinicians are providing virtual visits in real time through secure, interactive video exchange. These telehealth visits address a wide range of issues, from urgent to chronic, from primary care to subspecialty consultation, and from initial diagnosis to follow-up and management.As the largest health care delivery platform in the United States, the primary care setting 1 offers great potential for expanding telehealth use. TeleThis article was externally peer reviewed.

Exposure to and attitudes regarding electronic healthcare (e‐Health) among physician assistants in Canada: A national survey study

“…For example, PAs who responded to the survey were working mostly in the areas of family and emergency medicine; busy programmes where the adoption of unique e‐Health solutions could be limited. Despite high interest among primary care providers, uptake of telehealth has been described as challenging (Moore et al, ). Conversely, specialty programmes that focus on certain diseases may adopt e‐Health solutions that focus on those ailments (Voruganti et al, ).…”

“…The evidence for e‐Health in our healthcare system is building, elaborating on patient preferences with the use of e‐Health and areas of specialty care in which it can be appropriately implemented (Asan et al, ; Rai, Vigod, & Hensel, ; Zulman et al, ). A common limiting factor for e‐Health implementation is time and in some cases, payment for services (Moore et al, ). As salary‐based practitioners and physician extenders, PAs may be well positioned to assist with adoption and delivery of evidence‐based e‐Health interventions.…”

“…Despite its potential and a rapidly growing number of tools available, there continues to be barriers in the uptake and integration of e‐Health into practice (Moore et al, ; Swinkels et al, ). Even telehealth, which has enormous potential to bridge geographical access barriers, has been slow to achieve widespread adoption in some settings (Dorsey & Topol, ; Moore et al, ). In part, adoption challenges may be attributable to physician workloads and funding mechanisms, especially in the case of fee‐for‐service physicians (Moore et al, ).…”

“…Despite its potential and a rapidly growing number of tools available, there continues to be barriers in the uptake and integration of e-Health into practice (Moore et al, 2017;Swinkels et al, 2018).…”

Research on Clinical Decisions Made Daily in Family Medicine

“…Yet, telehealth remains a small part of health care overall. Moore et al 7 report a nationwide survey, providing an update on family physicians' current provision of telehealth (low) and views of barriers. For family physicians to increase their provision of telehealth services, we would require (1) sufficient reimbursement dollars for it to be a good use of time, (2) reorganization of office and patient schedules, and (3) more evidence of how it efficiently improves health outcomes.…”