Multidisciplinary Clinical Case Study

Early Impacts of the COVID-19 Pandemic on Telehealth Patterns in Primary Care, Mental Health, and Specialty Care Facilities in Texas

Authors: Omolola E. Adepoju, PhD, MPH, Minji Chae, BS, MS, M. Femi Ayadi, PhD, Omar Matuk-Villazon, MD, Winston Liaw, MD, MPH

Abstract

Objectives: Since the onset of the coronavirus disease 2019 (COVID-19) pandemic, many US clinics have shifted some or all of their practice from in-person to virtual visits. In this study, we assessed the use of telehealth among primary care and specialty clinics, by targeting healthcare administrators via multiple channels.

Methods: Using an online survey, we assessed the use of, barriers to, and reimbursement for telehealth. Respondents included clinic administrators (chief executive officers, vice presidents, directors, and senior-level managers).

Results: A total of 85 complete responses were recorded, 79% of which represented solo or group practices and 63% reported a daily patient census >50. The proportion of clinics that delivered ≥50% of their consults using telehealth increased from 16% in March to 42% in April, 35% in May, and 30% in June. Clinics identified problems with telehealth reimbursement; although 63% of clinics reported that ≥75% of their telehealth consults were reimbursed, only 51% indicated that ≥75% of their telehealth visits were reimbursed at par with in-person office visits. Sixty-five percent of clinics reported having basic or foundational telehealth services, whereas only 9% of clinics reported advanced telehealth maturity. Value-based care participating clinics were more likely to report advanced telehealth services (27%), compared with non-value-based care clinics (3%).

Conclusions: These findings highlight the adaptability of clinics to quickly transition and adopt telehealth. Uncertainty about reimbursement and policy changes may make the shift temporal, however.
Posted in: Infectious Disease143

Full Article

Having trouble viewing the article content below? Click here to open it directly.

Images

Download Image

Download Image

References

1. Marcin JP, Shaikh U, Steinhorn RH. Addressing health disparities in rural communities using telehealth. Pediatr Res 2016;79:169–176.
 
2. US Department of Health and Human Services. Report to Congress: E-health and telemedicine. https://aspe.hhs.gov/system/files/pdf/206751/ TelemedicineE-HealthReport.pdf. Published August 12, 2016. Accessed August 28, 2020.
 
3. American Hospital Association Center for Innovation. Telehealth: a path to virtual integrated care. https://www.aha.org/center/emerging-issues/marketinsights/telehealth/path-virtual-integrated-care. Accessed August 28, 2020.
 
4. Dorsey ER, Topol EJ. State of telehealth. N Engl J Med 2016;375:154–161.
 
5. Chi N-C, Demiris G. A systematic review of telehealth tools and interventions to support family caregivers. J Telemed Telecare 2015;21:37–44.
 
6. Moran JJA, Roudsari AV. The importance of telehealth for directors and other decision makers. Stud Health Technol Inform 2015;208:7–11.
 
7. Makhni MC, Riew GJ, Sumathipala MG. Telemedicine in orthopaedic surgery: challenges and opportunities. J Bone Joint Surg Am 2020;102: 1109–1115.
 
8. Baker-Whitcomb A, Harvey J. Benefits and barriers to telehealth credentialing by proxy. Telemed e-Health 2018;24:922–926.
 
9. Contreras CM, Metzger GA, Beane JD, et al. Telemedicine: patient-provider clinical engagement during the COVID-19 pandemic and beyond. J Gastrointest Surg 2020;24:1692–1697.
 
10. Bajowala SS, Milosch J, Bansal C. Telemedicine pays: billing and coding update. Curr Allergy Asthma Rep 2020;20:1–9.