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
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 Disease146
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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.
