People who are younger, more affluent and do not have established healthcare relationships are more likely to use a telemedicine program that allows them to get medical help — including prescriptions — by talking to a doctor over the telephone, according to a new RAND Corporation study.
Those who used the service suffered from a wide assortment of acute medical problems, the majority of which included respiratory illnesses, urinary tract infections and skin problems, and received proper diagnoses and treatments, researchers found. Other reasons for visiting the service included abdominal pain, back and joint problems, viral illnesses, eye problems and ear infections.
The findings, published in the journal Health Affairs, are from the first assessment of a telemedicine program offered to a large, diverse group of patients across the United States. Researchers studied 3,701 patient “visits” provided from April were covered through a health plan offered by the California Public Employees’ Retirement System, which provides health insurance to the state’s public workers. Patients who used Teladoc were compared to peers who visited hospital emergency departments (EDs) or a doctor’s office for a similar problem.
To use the Teladoc service, patients establish an online account containing information about their medical history. When they need care, they request a consult with a Teladoc physician. The patient does not have a relationship with their consulting doctor, but callbacks usually occur within 20 to 25 minutes. Though telemedicine has promise, Teladoc visits accounted for only a very small proportion of the healthcare used by the group studied.
Teladoc users as a group were younger, had fewer chronic conditions and were less likely to have used healthcare in the previous year when compared to other enrollees who used a hospital emergency department or visited a physician’s office for similar conditions. Teladoc users were slightly more likely to be women and live in more affluent areas.
In addition, more than a third of Teladoc visits occurred on weekends or holidays.
Across the leading conditions, visits to Teladoc were less likely than visits to the emergency department or a physician office to result in a follow-up visit for a similar condition. RAND researchers say the finding suggests that health problems were most likely adequately addressed during the Teladoc visits.
However, researchers caution that more research is necessary to further assess the quality and safety of telemedicine services such as Teladoc.
There are concerns that expanded use of this type of telemedicine may lead to fragmentation of care. Teladoc physicians do not have access to information that can be gathered during a patient exam or diagnostic testing. Some providers fear these and other limitations can lead to misdiagnosis and higher rates of follow-up visits.
Interest has grown in telemedicine programs because of the shortage of primary care physicians, which will likely worsen as more Americans acquire medical coverage under the ACA. Telemedicine is one of the alternatives touted as a way to better provide primary health care without greatly expanding the number of doctors.
Source: RAND Corporation, February 3, 2014
2013 Healthcare Benchmarks: Telehealth & Telemedicine provides actionable new information from more than 125 healthcare organizations on their utilization of telehealth and telemedicine, documenting trends and metrics on current and planned telehealth and telemedicine initiatives and including a year-over-year comparison of telehealth trends from 2009 to present.