Telehealth-enabled acute care does not drive in-person follow-ups

Synchronous telehealth appears to be an effective tool in diagnosing and treating acute care conditions without resulting in high rates of in-person follow-up care, according to research published in Cureus.

Conducted by researchers from Mayo Clinic in Jacksonville and Florida Atlantic University Charles E. Schmidt College of Medicine, the study aimed to assess the efficacy of telehealth visits in managing acute illnesses or conditions in primary care practices.

As telehealth adoption and use skyrocketed during the COVID-19 pandemic, the benefits associated with the care modality became increasingly apparent. However, the researchers contended that evidence on the effectiveness of telehealth visits for managing acute care conditions is limited compared to research on telehealth benefits in managing chronic conditions.

Thus, the researchers’ primary goal with this study was to estimate the proportion of patients receiving telehealth-based services for an acute care need who then required a face-to-face visit for the same need within 30 days of the virtual visit. The researchers also sought to identify the acute care needs best suited for telehealth visits.

The researchers used EHR data to identify all telehealth visit visits completed in a family medicine clinic from March 1, 2020, to June 30, 2020. They identified patients with acute care complaints requiring an in-office visit within 30 and 60 days of the telehealth visit. They also reviewed charts for patients who came back for an in-person visit that was not provider-directed to determine if their diagnosis had changed.

The study sample included 349 telehealth visits for 303 patients. Fifty patients (16.5 percent) returned for an in-person visit within 30 days of the telehealth visit, and 71 (23.6 percent) returned for a telehealth visit within 60 days.

The most common diagnoses were cough, anxiety, sinusitis, diarrhea, back pain, and sore throat. Patients with coughs and sore throats had the highest rate of in-person return. About 15 percent of the 32 patients with a cough returned for an in-person visit, as did 20 percent of the 20 patients with a sore throat.

The researchers found that 38 percent of those who returned for an in-person visit did not have a change in diagnosis. In some cases, the diagnosis made during the telehealth visit was only slightly different from the in-person visit. In addition, none of the patients who returned for a telehealth visit after 30 days but before 60 days were seen for the same complaint.

“The results of this research indicate that telehealth appointments can effectively diagnose and treat patients with acute illnesses,” the researchers concluded. “Furthermore, in-person follow-up care is often unnecessary.”

The research underscores previous findings on virtual primary care and its association with follow-up visits.

A study released by Epic Research last year shows that most primary care-related telehealth visits did not result in in-person follow-up visits. The researchers reviewed 18.6 million telehealth visits for primary care between March 1, 2020, and Oct. 15, 2022, for the study.

They found that 61 percent of primary care telehealth visits did not require an in-person follow-up within three months in the same primary care specialty. They also observed that pediatric primary care visits were the most likely to require an in-person visit following a telehealth visit, with 46 percent of visits resulting in an in-person follow-up.

Additionally, survey results show that Americans have a favorable view of virtual primary care. The 2022 survey polled more than 5,000 US adults aged 18 and over.

About 79 percent of survey participants believed virtual primary care allowed them to take charge of their health, and 94 percent were satisfied with their experience. Further, 35 percent of the respondents said virtual primary care was convenient, and 31 percent found it accessible.