Study: Changes Are Needed to Make Telehealth a Primary Care Platform

While telehealth use has skyrocketed during the coronavirus pandemic, not everyone has made the jump to virtual care – and that could be putting some people in danger.

A recent study out of Johns Hopkins finds that primary care visits have decreased by more than 20 percent since 2018, while blood pressure check-ups have been cut in half and cholesterol check-ups have dropped by 37 percent.

The implication is that people may be using connected health platforms to access urgent care, but they aren’t keeping up with their annual visits to the doctor’s office or undergoing basic health and wellness tests like cardiovascular health check-ups. This, in turn, could lead to an increase in chronic conditions down the line.

As detailed in the Journal of the Journal of the American Medical Association (JAMA) last week, the team of researchers from Johns Hopkins analyzed more than 125 million primary care visits between 2018 and the middle of this year. While the number of visits was consistent in 2018 and 2019, they dropped 21.4 percent this year. Office-based visits were cut in half this year, while telehealth visits jumped from 1.4 million during the first quarter of 2018-19 to 4.8 million during the first quarter of 2020 and then to 35 million during the second quarter of this year.

More importantly, the researchers found that as primary care visits shifted from the office to a telehealth platform, the structure of those visits changed as well, with less attention paid to health and wellness tests that would have been done in person.

“If substantial primary care volume continues to be delivered using telemedicine, a focus on the content and quality of such encounters is inevitable,” the study concluded. “Despite findings in a systematic review of 86 articles demonstrating the feasibility and acceptance of telemedicine for use in primary care, to our knowledge, relatively few rigorous comparisons of clinical outcomes in office-based vs telemedicine encounters have been performed. Our finding that such visits were less likely to include blood pressure or cholesterol assessments underscores the limitation of telemedicine, at least in its current form, for an important component of primary care prevention and chronic disease management.”

The study points to the need to re-establish primary care visits with patients who have skipped them because of the COVID-19 emergency – and to emphasize health and wellness check-ups and chronic care management in telehealth.