Telemedicine adoption is picking up, but use is still uncommon

More consumers are using telemedicine for a variety of healthcare services, but the overall use is still relatively uncommon, according to a recent study published in JAMA.

Since 2005, telemedicine has been picking up more users, but the most rapid increase in usage happened only over the last two years in the study, 2016 and 2017.

Researchers from Harvard and the University of Pittsburgh School of Medicine looked at data between 2005 and 2017 from OptumLabs Data Warehouse, a private insurance and Medicare Advantage claims database of one large, private U.S. health plan. Telemedicine visits were grouped into three categories, including telemental visits, primary care telemedicine and other telemedicine.

Over the last decade or so, the rate of telemedicine use has picked up more rapidly over the last few years. The average annual compound rate of growth in telemedicine visits was 52 percent annually from 2005 to 2014, and 261 percent from 2015 to 2017. Annual telemedicine visits grew from 206 visits among all members in 2005 to 202,374 visits in 2017.

Primary care and telemental visits made up the majority of all telemedicine visits measured. Those using primary care telemedicine tended to be younger on average and were more likely to live in urban areas than users of telemental health, according to the research.

“In this sample, telemedicine for subspecialty care beyond mental health was uncommon, and despite the attention given to telemedicine for rural settings, most telemedicine users lived in urban areas,” Michael L. Barnett, MD, MS, study author and assistant professor of health policy and management at the Harvard T.H. Chan School of Public Health, et al. wrote.

Prior to 2016, primary care telemedicine visits grew 36 percent annually, before increasing “sharply” to 136,366 visits in 2017, the same year it became the most frequently used form of telemedicine. By comparison, telemental health grew 56 percent annually to 57,095 visits in 2017.

The data also revealed that telemedicine had an impact in areas with a shortage of healthcare professionals to meet the needs of consumers for certain services. For example, telemental health increased “significantly faster in counties with no psychiatrists and in states with comprehensive parity mandates,” where insurance providers must offer equal coverage to mental health conditions, the study found. The same association was not found with primary care telemedicine.

“Physician supply appears to be influential for telemental health but not for primary care telemedicine, the brisk adoption of which may reflect consumers seeking convenience rather than reflecting low primary care supply,” Barnett et al. concluded. “This evidence suggests that local coverage and reimbursement regulations may have influenced growth of telemental care but not primary care telemedicine.”