New Research Affirms Telehealth's Efficacy, Role in Expanding Mental Healthcare

Two new research papers published in NEJM Catalyst this week show that telehealth does not drive up healthcare utilization, is effective, and can be used to expand mental healthcare services to nursing home residents.

University of Rochester Medical Center (URMC) researchers published the papers.

The first paper tackles three common concerns about telehealth use: that telehealth will reduce access to care for vulnerable populations, that reimbursing telehealth services at the same rate as in-person care would result in overuse, and that telehealth is an ineffective mode of care delivery.

Researchers gathered URMC data from July to December in both 2019 and 2020. They also collected data from January to June 2021, which they categorized as the follow-up period.

They examined various types of data, including patient demographics, outcomes, provider use, and completed visits.

"We really dug into the data, and it disproved all three concerns, which is really quite exciting," said Kathleen Fear, PhD, lead author of the paper and director of data and analytics at the UR Health Lab, in a press release.

The analysis revealed that the most vulnerable patients receiving care at URMC had the highest uptake of telehealth, with higher rates of visit completion and lower no-show and cancellation rates than their counterparts.

Further, researchers found that virtual care providers do not excessively order additional testing, and patients do not end up in the emergency room more often or need more in-person follow-ups due to ineffective telehealth encounters.

Fear also noted that the researchers did not observe any increase in adverse outcomes related to telehealth.

"This doesn't mean telemedicine will replace in-person care, but it's clear that it can help people access care more consistently and comfortably and that it provides a highly effective complement to traditional care," she said.

The second paper assessed URMC's nursing home-focused behavioral health program. The program comprises onsite psychiatric nurse support, telepsychiatry, telepsychotherapy, and telementoring.

Researchers examined data from 29 nursing homes that implemented the program before the pandemic. They found that between 2017 and 2019, antipsychotic use among long-stay residents in the facilities decreased by 37 percent.

During the pandemic, the program was expanded to 53 nursing homes. Antipsychotic use among long-stay residents in these nursing homes also decreased.

"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," said Adam Simning, MD, PhD, lead author of the study and an assistant professor of psychiatry at URMC, in the press release.

The New York State Office of Mental Health will fund the expansion of the program to nursing homes statewide, according to the paper.

The new research bolsters the growing evidence of telehealth's efficacy as providers increasingly implement virtual care options.

Last week, Intermountain Healthcare announced the addition of pediatric telehealth services that will enable emergency department (ED) physicians systemwide to consult with ED staff at Primary Children's Hospital.

Further, recent survey data from the American Medical Association shows that the proportion of physicians that said they were using virtual visit tools jumped from 14 percent in 2016 to 80 percent in 2022.