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      Which Provides The Best Care? IN-PERSON or Telehealth visits?

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      Which is more effective for treating patients? Telehealth or office visits? It’s a question being asked by legions of patients and healthcare providers these days, especially as pandemic-era telehealth continues to grow in popularity. The answer? According to new research by Kaiser Permanente, it might surprise you.

      Study on Follow-Up Appointments Offers Good News for Telehealth

      To arrive at its answer, they conducted a study of follow-up appointments for telehealth and office visits to the number of follow-up appointments scheduled with primary care providers after telehealth visits vs. office visits. The thinking was that if there was a significantly higher percentage of follow-up appointments after telehealth visits, for example, then it might be reasonable to conclude that office visits were the optimal healthcare option.

      What researchers discovered, however, was that only slightly more telehealth patients scheduled follow-up visits, but that the numbers for telehealth and office visits were otherwise remarkably comparable.

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      What makes these findings especially intriguing is that the Kaiser research was conducted prior to the COVID-19 pandemic when telehealth visits spiked dramatically.

      Between 2016 and mid-2018, researchers analyzed all 2.2 million primary care video, telephone, and in-person visits that had been scheduled online by Kaiser Permanente members in northern California. Of these, 86% of Kaiser patients made office visits; 14% had phone or video visits. Researchers found that all three types (office, phone, video) experienced similar rates of follow-up care. This included hospitalizations and emergency department visits, for which there was no significant difference in either case.

      “This study answers the previously open question about whether video and phone visits are less efficient because the bulk of patients might have to come to the clinic anyway to resolve their clinical issue,” says lead author Dr. Mary Reed, a research scientist with the Kaiser Permanente division of research. She adds:

       

      “We found there is a small margin of additional patients who return for an in-person visit after telemedicine, but it is surprisingly small: less than 2%. That can put to rest some of the concerns about telemedicine’s overall efficiency for primary care."

      The Kaiser Permanente research was published November 16 in JAMA Network Open.

      Prescriptions, Labs More likely for Office Visits. Why?

      Exactly how much separation was there between visit types and percent of follow-up visits? Not much:

      • Video visits:       25.4%
      • Telephone visits: 26.0%
      • Office visits:      24.5%

      To qualify for this comparison, follow-up visits needed to be made within seven days of the initial visit. Despite the close margins on follow-up appointments, there were significant differences to be found between telemedicine and in-person office visits when it came to prescription medication and lab tests:

        Prescription Medication Lab tests & imaging
      Video visits 38.6% 29.2%
      Telephone visits 34.7% 27.3%
      Office visits 60% 59.3%

       

      Why the disparity? It likely depended on the nature of the patient’s medical complaint, according to Reed. That is, the more severe the patient’s condition or complaint, the more likely they are to see their provider face to face – and therefore the more likely the providers were to take additional measures.

      “It is possible that these differences in treatment might be driven by the types or seriousness of concerns that patients chose for each visit type, or by the degree to which physicians could assess the patient in each visit type,” she says. “We need to explore these details further in future research.”

      substance abuse ehr system informationThe Kaiser researchers acknowledge that their findings might differ from those at other healthcare organizations. For example, they explain, their providers conduct both virtual and clinical visits, which leads to continuity of care for individual patients – care that is enhanced by a fully integrated EHR system that gives all Kaiser providers access to the health records of all Kaiser patients.

      Why would this make a difference? Because they suggest, telehealth providers who lack ongoing relationships with patients – or full access to their medical history – are more likely to prescribe different treatments such as increased antibiotics when less would have sufficed.

      “In contrast to prior studies of direct-to-consumer telemedicine, we did not find evidence of over-ordering or over-prescribing among patients using telemedicine to visit their own primary care doctors,” the report says. “Video or telephone visits may be a convenient and safe way for patients to address some primary care needs without generating a substantial number of follow-up office visits or experiencing health events.”

      The findings support virtual visits as an option for patients in an integrated care delivery model without increasing emergency department and hospital utilization, says Dr. Sameer Awsare, associate executive director of The Permanente Medical Group.

      Many Advantages to InSync Telehealth Software

      Literally and figuratively, telehealth has proved to be a lifesaver for patients and medical practices during the ongoing pandemic. In addition to convenience and quality of care, its advantages include:

      • Fewer missed or canceled appointments
      • Fewer geographic boundaries, which means more potential patients
      • Greater access to care for those living in remote regions
      • Patients less limited by social determinants of health

      Telehealth services are among the more popular and necessary EHR software features that InSync Healthcare Solutions provides to thousands of practices and specialists across all 50 states.

      For a closer look at how our software system can dramatically improve workflows in your practice, schedule a demo now with one of our experts. We're happy to answer questions and explain how we can tailor our electronic health record EHR system to meet your particular needs.

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