Safety-Net Facilities Continue to Rely on Audio-Only Telehealth
Researchers found that telehealth through audio-only platforms remained popular in federally qualified health centers during the pandemic, particularly for behavioral health services.
Audio-only telehealth visit volumes remained higher than video-based care at safety-net health clinics through the COVID-19 pandemic, especially for behavioral health services, according to a RAND Corporation report.
The RAND study gathered data on both in-person and virtual care from 45 federally qualified health centers in California between February 2019 and August 2021.
Overall, visit volumes remained consistent during this period, but the share of virtual visits increased. Audio-only visits were more popular than video for primary care and behavioral health during most of the study period.
“We found that 18 months after the start of the pandemic, many safety-net clinics were still relying on audio-only telehealth for many of their services,” said Lori Uscher-Pines, lead author of the study and a senior policy researcher at RAND, in the press release. “More effort is needed to understand the ideal mix of in-person, video and audio-only visits for different conditions to support quality health care.”
The most popular types of visits conducted through telehealth were those relating to behavioral health. In August 2021, this was the only type of visit for which patients used telehealth more frequently than in-person care.
The use of video visits was more inconsistent; however, health centers that provided services through video developed programs such as telehealth navigation, assessing digital literacy, and one-on-one training for patients.
Though the study indicates the popularity of audio-only visits in safety-net settings, researchers said more information is needed to identify an optimal balance between in-person and virtual care.
“If too many visits are occurring via telehealth, it’s likely that patients will miss out on needed preventive care such as vaccinations or the opportunity to detect issues early in a physical exam,” Uscher-Pines said. “But how much telehealth is too much? We just don’t know yet at this point in time.”
As providers weigh the benefits of in-person versus virtual care, states appear keen to solidify access to audio-only telehealth.
In December 2021, the Office of the Insurance Commissioner in Washington State decided to implement audio-only telehealth permanently. This new regulation will ensure that providers are reimbursed for audio-only services to the same extent as in-person services.
Further, previous research has also shown that audio-only telehealth could help close gaps in virtual care.
Another study from November 2021 older patients. The study found that the average age of audio-only users was 71 to 75 years and that more than half of Black patients used this telehealth modality.