Researchers Seek to Dispel Myths About Telehealth's Impact
Researchers at the University of Rochester Medical Center (URMC) in New York have published a paper in NEJM Catalyst that uses the academic medical center’s own experience during the pandemic to try to dispel some myths around telehealth.
Noting that as the pandemic starts to ease, payers might decide to reduce financial support for telehealth, the URMC research team used data generated in part during the COVID pandemic to examine three specific concerns:
• That telehealth will reduce access to care for the most vulnerable patients who may be unable to access digital services;
• That reimbursing providers for telemedicine services at the same rate as traditional services will encourage telemedicine overuse; and
• That telemedicine is not an effective way to provide care.
The URMC research found that the most vulnerable patients had the highest uptake of telemedicine and did so with lower no-show and cancellation rates. They also found that providers are not ordering excessive amounts of additional testing to make up for any limitations of virtual visits, and telehealth use is not leading to more patients ending up in the emergency room due to a lack of in-person visits.
“For patients, the message is clear and reassuring: Telemedicine is an effective and efficient way of receiving many kinds of healthcare,” said Kathleen Fear, Ph.D., lead author of the paper, “Busting Myths about the Impact of Telemedicine Parity,” and director of data and analytics at the UR Health Lab, in a statement. “Especially for those with transportation challenges, it is a service that really fills a gap – and, vitally, it does not compromise the quality of the care that patients receive. We really dug into the data, and it disproved all three concerns, which is really quite exciting,” Fear added. “Not only did our most vulnerable patients not get left behind—they were among those engaging the most with, and benefiting the most from, telemedicine services. We did not see worse outcomes or increased costs, or patients needing an increased amount of in-person follow-up. Nor did we find evidence of overuse. This is good care, and it is equitable care for vulnerable populations.”
Michael Hasselberg, Ph.D., R.N., URMC’s chief digital health officer and the study’s senior author, is quoted in a story on the URMC website as saying the paper marks the first time anyone has published comprehensive data refuting the three myths, whose persistence has limited the adoption of telemedicine nationwide. URMC researchers studied the work of more than 3,000 providers across the health system who engage in telemedicine and the UR Health Lab’s ability to analyze the data generated by their work.
A second URMC study published in NEJM Catalyst looked at a program URMC physicians developed to bring psychiatric and psychotherapeutic resources to nursing home patients through a combination of telehealth, on-site visits and staff education. The researchers concluded that the program improved access to care and reduced the number of residents requiring anti-psychotic medication.
“With a small team that we assembled here at URMC, we’ve been able to have a huge reach, extending care to patients in parts of the state where high-quality mental health services are scarce at best,” said Adam Simning, M.D., Ph.D., assistant professor of psychiatry and the study’s lead author, in a statement. “At a time when nursing homes nationwide are severely understaffed, and the need for mental health services among their residents is increasing, we’ve efficiently redesigned the way mental health services are provided to the more than 50 nursing homes we work with.”
