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Many telehealth appointments see fewer follow-ups than office visits, study finds

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In most specialties, people were more likely to have a second appointment after seeing a provider in person, new research from Epic suggests.

Patients who saw a specialist in person are more likely to see that provider in person than those seeing specialists via telehealth, according to new research from Epic.

Epic researchers examined millions of records from specialists and primary care providers. Researchers found that in 16 of 24 specialties analyzed by Epic, patients were more likely to get a second appointment within 90 days after seeing a doctor in person than in a telehealth visit.

For health systems and medical practices, the study suggests that telehealth appointments in specialties aren’t going to automatically lead to office visits.

The biggest disparity came in mental health appointments, according to Epic researchers. For mental health visits, patients who saw a doctor in person were 30% more likely to get a follow-up appointment than those who saw a provider virtually.

In mental health, 10% of telehealth visits had a follow-up appointment in 90 days, compared to 40% of mental health visits where patients saw a doctor in person.

In addition, patients who saw specialists in physical medicine and rehabilitation and pain medicine were at least 20% more likely to have a follow-up appointment after an in-person visit.

Conversely, patients who saw podiatrists and ob/gyn specialists were more likely to have a follow-up appointment with a telehealth appointment.

The gap between office visits and telehealth appointments closed significantly when it came to primary care.

Patients who saw a family medicine physician were narrowly more likely (0.2%) to have a follow-up appointment after an in-person visit. Patients who saw a pediatrician and an internal medicine physician virtually were slightly more likely to have a follow-up appointment (0.8% and 2.1%, respectively).

It’s worth noting that in many specialties, patients are more likely to see a provider in person, Epic says. In 2022 and early 2023, mental health and sleep medicine were the only two specialties where at least 20% of appointments were done via telehealth.

Epic says researchers examined more than 40.6 million specialty appointments and 32.1 million primary care visits from January 2022 to March 2023.

In recent months, Epic has produced other studies offering clues that telehealth appointments aren’t necessarily precursors to seeing providers in an office.

In most virtual appointments for primary care, patients haven’t had a follow-up appointment in person within 90 days, according to Epic research in March. Similarly, most patients who saw specialists virtually didn’t need an office visit in 90 days.

Jackie Gerhart, vice president of clinical informatics at Epic, told Chief Healthcare Executive® in January that telehealth is offering patients more options for a host of different specialties.

“We've been surprised at how many different conditions we can take care of through telemedicine that we hadn't thought of doing before,” Gerhart said.

(See part of our January conversation with Epic’s Jackie Gerhart in this video.)


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