Understanding Telemedicine's “New Normal”: Variations in Telemedicine Use by Specialty Line and Patient Demographics

Drake, Connor; Lian, Tyler; Cameron, Blake; Medynskaya, Kate; Bosworth, Hayden B.; Shah, Komal

doi:10.1089/tmj.2021.0041

Cited by 126 publications

(104 citation statements)

References 40 publications

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“…In contrast, Drake et al's study reported black patients 10% less likely than those of white race to use telemedicine (OR = 0.90, 95% CI: 0.88-0.91). [16] Kakani et al's study showed no significant difference in telemedicine use between black and white patients (OR = 0.98, 95% CI: 0.92-1.04). [15] Although the Drake and Kakani studies used academic health center encounter data, the studies were conducted in geographically different regions of the country, North Carolina and California, respectively.…”

Section: Discussionmentioning

confidence: 93%

Telemedicine use in 2020 during the COVID-19 pandemic among community dwelling U.S. Medicare beneficiaries

Davis–Ajami

Zhiqiang

2021

JHA

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Objective: CMS reimbursement regulations for telemedicine changed after the onset of the COVID-19 pandemic. This study aimed to assess telemedicine utilization patterns offered by health care providers and used by Medicare beneficiaries during the COVID-19 pandemic during 2020.Methods: This study used the Fall 2020 Medicare Current Beneficiary Survey (MCBS) supplemental COVID-19 survey to identify Medicare beneficiaries (≥ 65 years) with a regular place for medical care that offered telemedicine during 2020. Major outcomes: prevalence for whether telemedicine was offered before and during the pandemic, telemedicine use, and digital access to telemedicine. Logistic regression identified the demographic factors associated with telemedicine use.Results: The study sample included 4,380 eligible individual Medicare beneficiaries ≥ 65 years. Of those, 42.9% made telemedicine visits during the pandemic. Approximately 60% of the telemedicine visits were conducted via telephone. Telemedicine was offered to 18% of the respondents before the pandemic vs. 64% during year 2020 of the pandemic. Among telemedicine users, 57.2%, 28.3%, and 14.5% used voice calls, video calls, and both voice and video calls for health care appointments, respectively. Overall telemedicine use varied by sex, race, and region. Individuals 65-74 years, female, living in a metropolitan area, with higher incomes were more likely to make video visits. Experience using telecommunications via the internet influenced telemedicine use significantly.Conclusions: Telemedicine offered to older Medicare beneficiaries increased dramatically after the onset of the COVID-19 pandemic. Yet, less than half used telemedicine and differences in utilization existed by demographic characteristics.

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Section: Discussionmentioning

confidence: 93%

Telemedicine use in 2020 during the COVID-19 pandemic among community dwelling U.S. Medicare beneficiaries

Davis–Ajami

Zhiqiang

2021

JHA

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“…Finally, our primary outcome was focused on forward triage, the ability to minimize in-person encounters. 20 Future studies with comparator groups are required to investigate the effectiveness of telemedicine for key metrics such as patient outcomes, cost-effectiveness, and sustainability. 11 , 21 …”

Section: Discussionmentioning

confidence: 99%

Telemedicine as a component of forward triage in a pandemic

et al. 2021

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Objective(s) Coronavirus disease 2019 (COVID-19) presents an enormous challenge to healthcare systems globally. Optimizing access to healthcare while minimizing face-to-face patient encounters is critical to limiting exposures, conserving resources, and preserving health. We aimed to evaluate the utility of a COVID-focused telehealth program in avoiding potential in-person visits while maintaining high patient satisfaction. Methods All patients with COVID-related virtual visits at our center between March and May 2020 were included. Demographic, satisfaction, and clinical information were gathered using a modified, validated telehealth satisfaction questionnaire disseminated via email or telephone. Data were analyzed using Stata. Results Of 581 eligible patients, 180 (31%) responded to the survey. Symptoms (73%) and possible exposure (22%) were the main reasons cited for pursuing a virtual visit; cough (44%) and fever (36%) were the most common presenting symptoms. Regarding patient satisfaction, most patients rated the experience as “very good” or “excellent”, and 94% of respondents said they would recommend COVID-focused triage through telehealth to others. Over 81% of patients indicated that, if telehealth was not an option, they would have sought an in-person encounter. Ultimately, only 27% of patients reported pursuing a face-to-face encounter after participating in the virtual visit. Conclusion Based on patient self-reporting, telemedicine potentially prevented face-to-face COVID-related encounters. Patients expressed satisfaction with the virtual process and were less likely to pursue in-person consultation. Leveraging a telehealth strategy for forward triage has the potential to reduce exposures while conserving healthcare resources.

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“…Nonetheless, our findings highlight demographic and clinical differences in health care use for SARS-CoV-2 testing across all care delivery settings, which can strategically inform outreach efforts for distinct populations. Without structural reforms, rapid implementation of telehealth and other new services may exacerbate inequities in access to care, 2 , 3 , 4 , 5 particularly if these investments come at the expense of other care sites.…”

Section: Discussionmentioning

confidence: 99%

“…The COVID-19 pandemic rapidly shifted care delivery toward telehealth and COVID-19 testing services. While utilization differences early in the pandemic have been described among commercially insured patients and in ambulatory care settings, 1 , 2 , 3 health care use patterns for SARS-CoV-2 testing and subsequent health care use remain unclear, especially among safety-net populations.…”

Section: Introductionmentioning

confidence: 99%

Patient Characteristics and Subsequent Health Care Use by Location of SARS-CoV-2 Testing Initiation in a Safety-Net Health System

et al. 2021

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Understanding Telemedicine's “New Normal”: Variations in Telemedicine Use by Specialty Line and Patient Demographics

Cited by 126 publications

References 40 publications

Telemedicine use in 2020 during the COVID-19 pandemic among community dwelling U.S. Medicare beneficiaries

Telemedicine use in 2020 during the COVID-19 pandemic among community dwelling U.S. Medicare beneficiaries

Telemedicine as a component of forward triage in a pandemic

Patient Characteristics and Subsequent Health Care Use by Location of SARS-CoV-2 Testing Initiation in a Safety-Net Health System

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