Even Before COVID-19, Telehealth Supported Timely Access to Primary Care

Telehealth helped patients gain more timely access to primary care compared to the barriers associated with in-person office visits, according to an Emory Healthcare study published in Telemedicine and e-Health.

Although patients are often unwilling to sway from the setting where they receive primary care, there is a possibility that revealing new options can change their beliefs.

Study participants received care at Kaiser Permanente Northern California (KPNC). Between 2016 and 2018, the portal where patients schedule their following appointment included a question regarding their visit type preference. The choices were in-person, video, and telephone.

The study results revealed that telemedicine was not as popular as in-person care, with only 14 percent of patients selecting this option. Of this small proportion of patients, almost all chose telephone-enabled care rather than video.

But, when comparing the number of days between scheduling and appointment dates, the telephone method averaged 1.8 days, video averaged 2.3, and in-person averaged 3.5. Also, 66.6 percent of telephone visits occurred within one day of their scheduling, which is considerably higher than both video (56.6 percent) and in-person (46.5 percent) appointments.

This indicates telemedicine's ability to ensure that patients get timely access to care.

"The convenience of telemedicine made it possible for [patients] to see trusted healthcare providers more quickly," said study author Ilana Graetz, PhD, an associate professor in the department of health policy and management at Emory University's Rollins School of Public Health, in an email. "For patients facing barriers to in-person care, without access to telemedicine, they may not be able to seek timely medical attention, which could have detrimental effects on their health."

But the study has several limitations, including ones that link to the characteristics of the participants. Researchers did not consider that certain conditions require in-person care, and the fact that the participant data were obtained from only one location could have influenced the results. Results could differ outside of KPNC and among KPNC patients that did not use the portal.

The COVID-19 pandemic may also have had a substantial effect on the results of this study.

Considering that all data was collected before the pandemic, it is very likely that the use of telehealth has increased.

But the study makes a compelling case for telehealth's effect on care access. The results even surprised some researchers.

"While I expected that telemedicine visits would be timelier, I didn’t expect that the effect would be as large as what we found," Graetz said. "On average, telephone visits were scheduled about 50 percent sooner than office visits — in 1.8 days instead of 3.5 days."

"Ensuring continued access to telemedicine by telephone and video may reduce disparities in healthcare access and improve the timeliness of care," she added.

Similarly, a study polling infectious disease patients also revealed patient preference for telehealth. Many ID patients had to travel long distances and dedicate a large portion of their budget to receive the in-person care they were accustomed to. But after being provided with data showing how much time and money telehealth could save, over three-quarters of ID patients said they were open to virtual care.