In 2016, 15.4% of physicians worked in practices that used telemedicine for a wide spectrum of patient interactions, including e-visits, and 11.2% of physicians worked in practices that used telemedicine for interactions between physicians and healthcare professionals.
Telemedicine has the potential to improve access to care and the quality of that care while reducing costs. However, usage among physicians remains low. According to a study published in Health Affairs that analyzed 2016 data, only 15.4% of physicians worked in practices that used telemedicine for a wide spectrum of patient interactions, including e-visits.
During the same year, 11.2% of the 3500 physicians that were evaluated worked in practices that used telemedicine for interactions between physicians and healthcare professionals.
The study, which estimated the prevalence of telemedicine use among physicians using the 2016 Physician Practice Benchmark Survey of the American Medical Association, is the first set of nationally representative estimates of this kind.
Surveyed physicians reported if they used telemedicine for 5 functions, 3 of which were for patient interaction (diagnosing or treating patients, following up with patients, and managing patients with chronic disease) and 2 of which were for healthcare professional interaction (having a specialty consultation and getting a second opinion). They also indicated if their practices used telemedicine in 3 different ways: videoconferencing, remote patient monitoring, and storing and forwarding of data.
Utilization for the 5 functions ranged from 11.2% for diagnosing or treating patients to 6.5% for getting a second opinion, and among the 3 telemedicine modalities, videoconferencing was reported most often (12.6%), followed by storing and forwarding of data (9.4%) and patient monitoring (7.3%). Remote patient monitoring was used by less than 10% of physicians in every broad specialty group, with the exception of internal medicine subspecialties (10.9%).
While specialties like radiology (39.5%), psychiatry (27.8%), and cardiology (24.1%) reported relatively high use of telemedicine for patient interaction, other specialties, including allergy/immunology (6.1%) and gastroenterology (7.9%), had low rates.
“Although radiologists, psychiatrists, and cardiologists had the highest use of telemedicine for this type of interaction, these percentages reflect a tide spectrum across specialties in how telemedicine was used to interact with patients,” noted the authors.
Among radiologists, 42.7% reported that their practice used telemedicine for storing and forwarding data and 37.4% reported that their practice used telemedicine to diagnose and treat patients. Meanwhile, 17.9% of cardiologists’ practices used patient monitoring and 19% used telemedicine to manage patients with chronic disease.
Emergency medicine physicians (38.8%), pathologists (30.4%), and radiologists (25.5%) were most likely to use telemedicine for interactions with healthcare professionals.
Location played a role in telemedicine utilization, with those in nonmetropolitan areas being more likely to report use of telemedicine for interactions with healthcare professionals compared with physicians in metropolitan locations. Videoconferencing was also used more often among those in nonmetropolitan areas.
“Physicians in larger practices were more likely than those in smaller practices to report the use of telemedicine,” added the researchers. “Use for patient interactions ranged from 8.2% among physicians in the smallest practice size category (1 to 4 physicians) to 26.5% among physicians in the largest (at least 50 physicians).”
Reflecting on the findings, the researchers suggest that despite regulatory and legislative changes aimed at encouraging the use of telemedicine, the financial burden of implementing it may be a continuing barrier, especially for small practices.
Kane C, Gillis K. The use of telemedicine by physicians: stil lthe exception rather than the rule [published online December 3, 2018]. Health Aff. doi: 10.1377/hlthaff.2018.05077.