From the Journals

Study: Few physicians use telemedicine



Just 15% of U.S. physician practices report using telemedicine for patient care, with use of the technology varying widely by specialty.

Carol Kane, director of economic and health policy research, and Kurt Gillis, principal economist, both of the American Medical Association, evaluated the responses of 3,500 physicians about their telemedicine usage through data from the AMA’s 2016 Physician Practice Benchmark Survey. They took into account physicians’ specialty, age, sex, practice setting, and region, as well as the type of telemedicine services employed, if any.

In a research article published in Health Affairs, they found that in 2016, 15% of medical practices used telemedicine for patient interactions – including e-visits and store and forward services – while 11% used the technology to communicate with other health professionals.

Of the primary three telemedicine modalities, physicians used videoconferencing most often (13%), followed by store and forward of data (9%), and remote patient monitoring (7%).

Of specialists, 40% of radiologists, 28% of psychiatrists, and 24% of cardiologists used telemedicine for patient interactions, Ms. Kane and Mr. Gillis found. Emergency physicians were most likely to use telemedicine for interactions with other health professionals (39%), followed by pathologists (30%), and radiologists 26%). On the lower end of the spectrum, 6% of immunologists, 9% of ob.gyns., and 10% of general surgeons used telemedicine for patient care.

Remote patient monitoring was the least used telemedicine modality, with less than 10% of physicians in every broad specialty group using the service, with the exception of internal medicine subspecialties. Cardiologists reported the highest use of remote patient monitoring, followed by nephrologists.

Practice size and setting markedly influenced the practice of telemedicine. Use for patient interactions ranged from 8% among physicians in practices with one to four doctors to 27% among physician practices with at least 50 physicians. Similarly, telemedicine use between physicians and other health care professionals ranged from 4% among doctors in the smallest practice category to 23% in the largest practice category. Physicians in solo practice were less likely to use telemedicine for patient interactions than physicians in single- or multispecialty group practices.

Unsurprisingly, rural physicians were more likely to use telemedicine to consult with other doctors and to use video conferencing with patients than were physicians in metropolitan areas. No significant differences in telemedicine use were observed between physicians in states with parity laws. Such laws generally require that commercial insurers cover and reimburse for telemedicine services as they would for in-person services.

SOURCE: Kane et al. Health Affairs. 2018. doi: 10.1377/hlthaff.2018.05077.

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