More on Telehealth

Doctor video visits increase access to healthcare but could risk fragmentation

Receiving consistent primary care leads to better overall health, but a lack of coordinated communication will be a concern.

Jeff Lagasse, Associate Editor

In today's fast-paced digital society, virtual doctor visits are on the rise and offer patients a more convenient way to receive medical care from anywhere. If someone can't leave work or doesn't have childcare, for example, online video visits can provide live, face-to-face physician consultations from the comfort of their home or office.

Telehealth, remote healthcare services that include video visits, eliminates historical barriers to healthcare such as geography, transportation or time constraints. A new study shows that receiving consistent primary care leads to better overall health, though telehealth does increase the risk of fragmentation if not handled appropriately.

Dr. Winston Liaw, chairman of the University of Houston College of Medicine Department of Health Systems and Population Health Sciences, led the study to examine the relationship between telehealth use and access to primary care; it was published in the Journal of the American Medical Informatics Association.


Researchers found that 90 percent of telehealth users chose a video visit for convenience and saved several hours of time. Nearly half said they couldn't see their doctor in-person that day because there were no appointments available or the office was closed.

The web-based survey of individuals with access to LiveHealth Online, a telemedicine platform operated by Anthem Blue Cross, also found that compared to non-users, telehealth users were less likely to have a usual source of care -- like a primary care physician -- indicating a preference for access over continuity.

Telehealth users were more likely to be educated, employed and live in a city, according to the study. This presents a challenge to make the service available to those who could benefit most, including underserved communities, and not just patients with resources.

As more video visit platforms emerge, Liaw is concerned about a lack of coordinated communication, potentially leading to further fragmentation of the healthcare system. On average, Medicare beneficiaries see seven physicians at four different practices, the study said, leading to duplicate services, conflicting advice and ultimately inefficiently delivered care.

The study concludes that to "enhance access without sacrificing coordination, telehealth will need to share information with primary care and vice versa. Without adequate sharing, errors can occur, and critical information will not be communicated to others."


Telehealth is proving to be more and more effective, especially in rural areas that lack brick-and-mortar care options. Elderly patients often find it useful since it eliminates the need for transportation.

But as the model gains traction, the focus is shifting away from the novelty of connected devices and new technology and more toward providing patients with top notch care -- and giving providers, physicians and nurses alike, the power to deliver it effectively.

Twitter: @JELagasse

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