Due in large part to the COVID-19 pandemic, telehealth has evolved from an alternative means of care to one of the primary ways in which many patients seek treatment.
That's reflected in the numbers: In 2020, virtual care is expected to account for more than 20% of all medical visits in the U.S., which in turn is projected to drive $29 billion in total healthcare services.
Those numbers were revealed this week in Doximity's 2020 State of Telemedicine Report, which also found that up to $106 billion of current U.S. healthcare spend could be virtualized by 2023. This highlights the high rates of adoption among both patients and physicians, and the impetus felt among providers to offer safe, secure and easy-to-use virtual services as demand for telehealth continues to grow.
WHAT'S THE IMPACT?
Medicare, Medicaid, and privately insured office visits will likely be virtualized in coming years, and telehealth will divert a significant percentage of emergency department visits, becoming an important adjunct to home healthcare support, the numbers showed.
Patients are largely on board with this paradigm shift. Prior to the pandemic, just 14% of Americans had tried telehealth at least once. Since the coronavirus outbreak, that number has increased by 57%, and for those with a chronic illness, the number has increased by 77%.
More than a quarter of patients said they feel more comfortable using virtual care platforms since before the public health emergency, and nearly the same percentage said they plan on using telehealth even when the pandemic ends. Doximity expects that number to rise as technology improves and more hospitals add it to their offerings.
Increasingly, patients report having a positive experience, with 28% saying they feel telehealth is the same or better quality than an in-person visit. Those with a chronic illness feel even more positive, with 53% saying it's the same or better.
The numbers also provided some insight into how Americans prefer to access virtual care, with 45% preferring their phones and 39% preferring laptops. That loosely mirrors broader usage patterns in areas beyond healthcare, and with 81% of Americans already owning a smartphone, the stage is set for providers who seek to use mobile devices as a way to bridge the digital divide in medicine.
For physicians, the number of those who self-reported telehealth as a skill increased annually by 20% between 2015 and 2018, and from 2019 to 2020 that number increased by 38%. Female physicians were 10% more likely to engage with telehealth job ads than were their male counterparts, and they also had higher engagement, using the virtual health platform at a 24% higher rate than males. Perhaps surprisingly, doctors in their 40s and 50s used telehealth more often than their younger colleagues.
The top 10 specialties utilizing remote care technologies, in order, were endocrinology, rheumatology, gastroenterology, nephrology; cardiology, urology, neurology, geriatrics, hematology/oncology and pulmonology.
Even though rural areas stand to gain the most from adding telehealth services, urban areas are adopting the technology more quickly. Massachusetts is the leading adopter to date, followed closely by North Carolina and New Jersey.
THE LARGER TREND
In August, the National Poll on Healthy Aging found that patient comfort levels with telehealth have increased. Back in 2019, most older adults expressed at least one serious concern about trying a telehealth visit. But by mid-2020, the percentage with such concerns had eased, especially among those who had experienced a virtual visit between March and June of this year.
Yet hurdles remain. A recent report from research firm KLAS found that nearly half of the 19 healthcare executives surveyed say that either telehealth functionality or capacity has been their primary problem to solve during the early stages of the COVID-19 crisis. Other major challenges include remote patient monitoring, interoperability, real-time data analytics, work-from-home resources and patient surveillance.
The Centers for Medicare and Medicaid Services is proposing to make some temporary telehealth flexibilities under the public health emergency permanent, based on an executive order from President Trump.
However, one big hurdle not yet addressed is whether the parity in payment between an in-person and a virtual visit will remain.
On Tuesday, the Taskforce for Telehealth Policy released its final report and recommendations to safeguard the future of telehealth following the end of the COVID-19 pandemic.