Researchers examined more than 300,000 virtual visits for patients older than 60 over the course of three years.
By Kat Jercich
A wide-ranging study published in the Journal of Telemedicine and Telecare this past month found that telehealth can be an effective modality of care for patients over 60, particularly when deployed in the confines of their existing primary care provider.
When researchers, including a team from the West Health Institute, which focuses on addressing the care needs of seniors, analyzed 313,516 telehealth visits across three healthcare organizations, they found that virtual encounters successfully resolved urgent and non-emergent needs in the vast majority of cases.
“While the median rate of visit resolution for telehealth visits was lower than clinically comparable in-person visits, telehealth was effective in resolving urgent, non-emergent conditions a high percentage of the time,” read the study.
WHY IT MATTERS
The COVID-19 pandemic has shone a new spotlight on the potential for telehealth to complement in-person care – especially for people who may face mobility challenges in going to a brick-and-mortar office.
For this study, researchers sought to examine telemedicine’s effectiveness and impact on downstream utilization for people over 60.
They examined more than 300,000 telehealth visits that had taken place at Kaiser Permanente Southern California, Spectrum Health and Jefferson Health from November 2015 through March 2019.
The study found that telehealth index visits were successful at resolving urgent, non-emergent needs between 84.0% and 86.7% of the time across the three organizations. Researchers noted that telemedicine is most commonly used by seniors for upper respiratory infections, UTIs and skin conditions, all of which were resolved at least 80% of the time with one visit.
When follow-up visits were warranted, the number of visits was largely similar to an in-person cohort – suggesting downstream utilization is similar.
Researchers pointed out that the study relied on the premise that if a patient did not see a provider within 30 days of initial visit, the condition was resolved – which may not have been true in all cases.
“Episodes of care or number of visits is only a single marker as to whether clinical quality of care was delivered, as a routine follow-up compared to follow-up for re-examination serve two different purposes,” they wrote.
THE LARGER TREND
Downstream utilization is a point of interest for many researchers around telehealth, given potential concerns about spending.
A recent study found, for example, that on-demand virtual care (as opposed to telemedicine visits by the patients’ primary care providers) may not lead to cost savings down the line.
Some stakeholders have said that coverage parity is required to ensure equity, while others say payment for virtual care should be lower.
ON THE RECORD
“While in-person visits have traditionally been the gold standard, our results suggest that when deployed within the confines of a senior’s existing primary care and health system provider, telehealth is an effective alternative to in-person care to address acute unplanned needs without increasing downstream utilization,” wrote researchers.
