A report by athenahealth finds a gender gap in the use of virtual care. Jessica Sweeney-Platt of athenahealth talked with Chief Healthcare Executive about telemedicine.
While telehealth is gaining in popularity, a new report by athenahealth reveals patients and providers are using virtual care differently.
Female patients are more likely to use telehealth than male patients, according to a report released today by athenahealth, the Massachusetts-based healthcare technology company. Female physicians are also more likely to use telemedicine than male doctors.
Jessica Sweeney-Platt, vice president of research and editorial strategy at athenahealth, talked with Chief Healthcare Executive about the telehealth report.
“The data absolutely say and absolutely show that male providers and male patients are significantly less likely to use telehealth than either female providers and female patients,” Sweeney-Platt said.
In addition, Black and Hispanic patients are using telehealth more than white patients, but they’re less likely to see the same provider. The study also found patients are turning to telehealth for mental health and to manage chronic conditions.
Hospital and health system executives should think about ways to use telehealth to connect with patients. “It is filling very real care gaps for patients,” Sweeney-Platt said.
Here are some highlights of the report. (See excerpts of our conversation with Jessica Sweeney-Platt in this video. The story continues below the video.)
Telehealth by gender
In 2021, male clinicians were 24% less likely to see patients in telehealth appointments than female physicians, according to the report. The report found the disparity widened throughout the year.
Male patients also used telehealth appointments 15% less than female patients, the report stated. Patients who visited one male provider had 60% lower odds of adoption compared to patients with a female provider.
While Sweeney-Platt said the gender differences among providers are clear, she said, “What’s harder to determine is whether that’s a good thing or a bad thing.”
“Is this a problem? I don’t know,” she said. “It’s consistent with other studies that have been done both using athenahealth data and other data that show very different practice patterns between male clinicians and female clinicians.”
Female physicians tend to spend more time with patients, and some have fewer visits in a day. As a result, while female physicians may be doing more to meet their patients needs, they can end up earning less if they see fewer patients. A study published in the New England Journal of Medicine in October 2020 found women primary care physicians spend, on average, an additional 2.4 minutes with their patients, and they generated 11% less in annual revenue.
With male physicians using telehealth less, should health system leaders spur them to see more patients virtually? Sweeney-Platt said it’s a tough question.
“I don’t know whether there is something that can or should be done about it but I think it’s interesting to add that insight,” she said. “These gender practice patterns seem to be showing up even in a relatively more recently widely adopted modality like telehealth. So we’re seeing in-person practice patterns playing out across virtual care as well.”
More doctors are using telehealth as a result of the COVID-19 pandemic. Four out of five doctors (80%) saw patients via telemedicine in 2022, according to a recent survey on physicians usage of digital tools from the American Medical Association (in 2016, only 14% engaged in virtual visits).
Differences in race
Black and Hispanic patients are taking advantage of telehealth, and they are more likely to engage in telemedicine than white patients, the study found.
However, Black and Hispanic patients are less likely to see one dedicated clinician or provider.
“If a white patient is using telehealth, it is more likely they are seeing a single provider across both in-person and telehealth visits,” Sweeney-Platt said. “Whereas if a Black or a Hispanic patient is using telehealth, it is less likely that the next visit that they have in person or telehealth will be with the same provider.”
Sweeney-Platt said the study raises interesting questions for hospitals and health systems.
“I think it’s an interesting challenge for health system executives to think about the role and the importance of continuity of care in the quality experience that they are providing to patients,” Sweeney-Platt said.
“This is consistent with another finding from the study which is that practice-level demographics were very important in terms of the likelihood of a patient using or not using telehealth,” she added. “So basically, if a practice decides that telehealth is a valuable form or a valuable means through which to engage with their patients, to provide access to patients, then patients not surprisingly will be more likely to use telehealth.”
Health system leaders should examine “the ways in which telehealth can be used to encourage continuity of care, as opposed to maybe further fragmenting the care experience,” Sweeney-Platt said.
Many health advocates say telehealth offers promise in making it easier for patients to access mental health services, and the report suggests patients find virtual care an appealing option.
One out of four survey participants (25%) said they scheduled a telehealth visit to address a new mental health concern, and 23% of respondents said they were more likely to seek mental health support because of the availability of telehealth.
That was “a very gratifying part of the findings,” Sweeney-Platt said.
“Telehealth does seem to be opening up access to services that people have had trouble accessing before, whether that was because of the time it takes to be treated for a mental health condition as opposed to a physical health condition,” she said.
“If the situation is acute, it could be once a week that you have to get to your clinician, maybe twice a week, maybe even more,” Sweeney-Platt added. “A virtual option removes some of that friction of having to take all of that time out of what is probably already a fully allocated schedule if you’re working, or you’re taking care of kids, or in school.”
Researchers found patients with substance use were less likely to have an overdose if they had telehealth appointments, according to a study published in JAMA Psychiatry last month.
Managing chronic conditions
Roughly a quarter (23%) of respondents said telehealth visits involved regular appointments to deal with chronic conditions.
“Patients with chronic conditions are more apt to use telehealth,” Sweeney-Platt said. “They are more apt to therefore have a higher number of visits, which is probably consistent with what you want for those patients, finding a way to further engage them in their own healthcare.”
At this point, there’s not much evidence suggesting telehealth is reducing touchpoints to the healthcare system, Sweeney-Platt said. And she noted some worry that’s a problem, because telehealth isn’t replacing in-person visits.
“That’s where I think the nuance of the story gets really interesting,” Sweeney-Platt said. “You do need more touchpoints. You don’t need to have them face to face.”
Health system leaders should think about “the role that telehealth can and should play as part of an entire continuum of care, not just thinking of it as a separate modality sitting over here,” Sweeney-Platt said. “How can and should it fit into the touch points that a patient has with the system and integrating that into that digital journey is something really interesting.”