Paying for Telemedicine After the Pandemic

Mehrotra, Ateev; Bhatia, R Sacha; Snoswell, Centaine L.

doi:10.1001/jama.2020.25706

Cited by 151 publications

(173 citation statements)

References 3 publications

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“…Addressing the challenges and making these regulatory changes will fundamentally alter primary care provision in the United States [ 78 , 79 ]. Telehealth appears to be firmly established in primary care, and adequate resources made available to sustain it into the post-pandemic era, including managing subsequent pandemics [ 80 ].…”

Section: Results: Pci Response To Covid-19mentioning

confidence: 99%

Primary Care Informatics Response to Covid-19 Pandemic: Adaptation, Progress, and Lessons from Four Countries with High ICT Development

et al. 2021

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Objective: Internationally, primary care practice had to transform in response to the COVID pandemic. Informatics issues included access, privacy, and security, as well as patient concerns of equity, safety, quality, and trust. This paper describes progress and lessons learned. Methods: IMIA Primary Care Informatics Working Group members from Australia, Canada, United Kingdom and United States developed a standardised template for collection of information. The template guided a rapid literature review. We also included experiential learning from primary care and public health perspectives. Results: All countries responded rapidly. Common themes included rapid reductions then transformation to virtual visits, pausing of non-COVID related informatics projects, all against a background of non-standardized digital development and disparate territory or state regulations and guidance. Common barriers in these four and in less-resourced countries included disparities in internet access and availability including bandwidth limitations when internet access was available, initial lack of coding standards, and fears of primary care clinicians that patients were delaying care despite the availability of televisits. Conclusions: Primary care clinicians were able to respond to the COVID crisis through telehealth and electronic record enabled change. However, the lack of coordinated national strategies and regulation, assurance of financial viability, and working in silos remained limitations. The potential for primary care informatics to transform current practice was highlighted. More research is needed to confirm preliminary observations and trends noted.

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Section: Results: Pci Response To Covid-19mentioning

confidence: 99%

Primary Care Informatics Response to Covid-19 Pandemic: Adaptation, Progress, and Lessons from Four Countries with High ICT Development

et al. 2021

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“…In this issue of JAMA, 2 articles discuss critical issues that will shape the future of virtual care after the pandemic: Mehrotra et al 6 address the dilemma of how governments and insurance companies will fund such care going forward; Herzer and Pronovost 7 focus on the challenges of ensuring quality.…”

mentioning

confidence: 99%

Virtual Care, Telemedicine Visits, and Real Connection in the Era of COVID-19

Zulman

Verghese

2021

JAMA

100

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“…The COVID-19 pandemic has led to a rapid increase in virtual care use across the globe [ 1 - 5 ]. In Ontario, Canada’s largest province, virtual care increased from 1.6% of all ambulatory visits pre–COVID-19 to 71% during the first wave of the COVID-19 pandemic [ 3 ], a much higher rate compared to those reported in other countries such as the United States (30%) and Australia (42%) [ 4 , 6 , 7 ].…”

Section: Introductionmentioning

confidence: 99%

Using Administrative Data to Explore Potentially Aberrant Provision of Virtual Care During COVID-19: Retrospective Cohort Study of Ontario Provincial Data

Stamenova¹,

Chu²,

Pang³

et al. 2021

J Med Internet Res

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Background The COVID-19 pandemic has led to a rapid increase in virtual care use across the globe. Many health care systems have responded by creating virtual care billing codes that allow physicians to see their patients over telephone or video. This rapid liberalization of billing requirements, both in Canada and other countries, has led to concerns about potential abuse, but empirical data are limited. Objective The objectives of this study were to examine whether there were substantial changes in physicians’ ambulatory visit volumes coinciding with the liberalization of virtual care billing rules and to describe the characteristics of physicians who significantly increased their ambulatory visit volumes during this period. We also sought to describe the relationship between visit volume changes in 2020 and the volumes of virtual care use among individual physicians and across specialties. Methods We conducted a population-based, retrospective cohort study using health administrative data from the Ontario Health Insurance Plan, which was linked to the ICES Physician Database. We identified a unique cohort of providers based on physicians’ billings and calculated the ratio of total in-person and virtual ambulatory visits over the period from January to June 2020 (virtual predominating) relative to that over the period from January to June 2019 (in-person predominating) for each physician. Based on these ratios, we then stratified physicians into four groups: low-, same-, high-, and very high–use physicians. We then calculated various demographic and practice characteristics of physicians in each group. Results Among 28,383 eligible physicians in 2020, the mean ratio of ambulatory visits in January to June 2020:2019 was 0.99 (SD 2.53; median 0.81, IQR 0.59-1.0). Out of 28,383 physicians, only 2672 (9.4%) fell into the high-use group and only 291 (1.0%) fell into the very high–use group. High-use physicians were younger, more recent graduates, more likely female, and less likely to be international graduates. They also had, on average, lower-volume practices. There was a significant positive correlation between percent virtual care and the 2020:2019 ratio only in the group of physicians who maintained their practice (R=0.35, P<.001). There was also a significant positive correlation between the 2020:2019 ratio and the percent virtual care per specialty (R=0.59, P<.01). Conclusions During the early stages of the pandemic, the introduction of virtual care did not lead to significant increases in visit volume. Our results provide reassuring evidence that relaxation of billing requirements early in the COVID-19 pandemic in Ontario were not associated with widespread and aberrant billing behaviors. Furthermore, the strong relationship between the ability to maintain practice volumes and the use of virtual care suggests that the introduction of virtual care allowed for continued access to care for patients.

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Paying for Telemedicine After the Pandemic

Cited by 151 publications

References 3 publications

Primary Care Informatics Response to Covid-19 Pandemic: Adaptation, Progress, and Lessons from Four Countries with High ICT Development

Primary Care Informatics Response to Covid-19 Pandemic: Adaptation, Progress, and Lessons from Four Countries with High ICT Development

Virtual Care, Telemedicine Visits, and Real Connection in the Era of COVID-19

Using Administrative Data to Explore Potentially Aberrant Provision of Virtual Care During COVID-19: Retrospective Cohort Study of Ontario Provincial Data

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