Emergency Room Follow-Ups Similar After Telehealth, In-Person Visits

Researchers from Johns Hopkins Bloomberg School of Public Health found that patients who participated in an initial visit through telehealth were not more likely to need emergency department follow-up visits than those who received care in person, except for cases related to respiratory infection, bronchitis, and pharyngitis.

In the study, which was published in JAMA Network Open, researchers collaborated with Blue Health Intelligence and the Digital Medicine Society to draw information from 40 million privately insured patients. The patients were younger than 65, and the data collected was from July to December 2020. Researchers found that 17 percent of non-emergency visits occurred through telehealth in this period. 

For 18 out of 21 conditions reviewed in the study, unplanned hospitalizations and follow-up emergency department visit rates were similar for in-person and telehealth visits within 14 days of the initial visit.

Among the remaining three conditions, respiratory infection, bronchitis, and pharyngitis, telehealth patients had higher rates of emergency department follow-up visits. For example, in cases involving a bronchitis diagnosis, telehealth patients were 1.18 times more likely to visit the emergency department and 1.23 times more likely to see the doctor again.

Researchers also noted that patients aged 18 to 34 were the heaviest telehealth users.

“The authors concluded that telehealth ensured continuity and access to care at the peak of the pandemic and remained widespread during the post-surge period in the second half of 2020. These findings can help policymakers, payers and healthcare providers better manage the use of telehealth in the months and years ahead,” said Joe Kvedar, MD, chair of the board of the American Telemedicine Association (ATA), in a statement emailed to mHealthIntelligence.  The study was funded with an ATA grant. The limitations of the study include the omission of Medicare, Medicaid, and uninsured patients and the inclusion of follow-up visits that occurred only within 14 days.

Since the beginning of the COVID-19 pandemic, various studies have indicated positive and negative results associated with the uptake of telehealth.

For example, a study from last month found that patients with acute conditions were more likely to need a follow-up visit after the initial use of telehealth. This conclusion was drawn from information regarding 40 million patients between 2019 and 2020.

Another study published in March found that 30-day heart failure readmissions were similar following telehealth and in-person follow-up appointments.

Further, a study from January 2021 noted that not all oncology professionals believed that telehealth enhanced care access. The study interviewed 29 medical oncology health professionals, some of whom stated that examining conditions such as sore throat, shortness of breath, and graft vs. host disease could occur through telehealth, while others disagreed.