Telemedicine use still rare among physicians

Telemedicine is a growing service, but its use is still rare among physicians, according to a recent research paper published in Health Affairs.

Just 15.4 percent of physicians worked in practices that used telemedicine in 2016, including for a variety of patient interactions such as e-visits and diagnoses by radiologists. The results gauge just how widespread telemedicine is among physicians, underscoring the service has a long way to go. In 2016, 11.2 percent of physicians worked in practices where telemedicine was used in interactions between physicians and other healthcare professionals.

The findings align with other recent research published in JAMA that found telemedicine use is rising, but is still relatively rare.

The research used data from the American Medical Association’s 2016 Physician Practice Benchmark Survey. Recent changes in regulations and legislation have opened the doors for more telemedicine use, but its potential to increase access to care, improve quality and lower costs has yet to be fully realized.

“While regulatory and legislative changes have been implemented to encourage the use of telemedicine, there are no nationally representative estimates on its use by physicians across all medical specialties,” Carol K. Kane, study co-author and AMA director of economic and health policy research, said in a statement. “To fill this information gap, the AMA study surveyed 3,500 physicians to provide needed data that will help assess potential barriers and create strategies to promote telemedicine adoption.”

Previous research has been based on Medicare claims data, but the prevalence of telemedicine use may be higher among beneficiaries covered by the Department of Veterans Affairs (VA). Up to 12 percent of VA beneficiaries receive some form of telehealth annually, compared to 0.2 percent of Medicare Part B fee-for-service beneficiaries.

In AMA’s survey, utilization rates varied across five functions, from 6.5 percent for getting a second opinion to 11.2 percent for diagnosing or treating patients. Videoconferencing was reported most often of the three telemedicine modalities captured in the data, with 12.6 percent of physicians who said it was used in their practice. Physicians also used remote patient monitoring (7.3 percent) and 9.4 percent reported storing or forwarding data.

Telemedicine use was higher among certain specialties. For instance, 27.8 percent of psychiatrists reported using telemedicine, while 24.1 percent of cardiologists worked in practices that used telemedicine for patient interactions, according to the data.

In addition, 39.5 percent of radiologists and 23 percent of pathologists reported their practices use telemedicine for patient interactions. These specialties rarely used telemedicine to follow up with patients or manage patients with chronic disease. However, 37.4 percent and 20.9 percent, respectively, used telemedicine to diagnose or treat patients, according to the data.

Emergency medicine physicians used videoconferencing the most (31.6 percent), followed by psychiatrists and pathologists, which each reported around 25 percent.

Larger practices were more likely to use telemedicine than smaller practices, with patient interactions ranging from 8.2 percent among physicians in smaller practices to 26.5 percent among physicians in practices with at least 50 physicians.

“These practices may be better able to make the investments necessary to support telemedicine,” Kane et. al wrote.

Not all physicians in these specialties used telemedicine at all, and even those that did may only use it for a subset of patients, according to researchers.

“Our work suggests that despite regulatory and legislative changes designed to encourage the use of telemedicine, the financial burden of implementing it may be a continuing barrier, especially for small practices,” Kane et. al concluded.