Good news about telehealth: It works

Three common myths about the effectiveness of telehealth are exactly that – myths, according to two new studies that examined its use during the COVID-19 pandemic.

Concerns about telehealth have stymied its use nationwide, but those fears are unwarranted, said researchers at the University of Rochester Medical Center (URMC). They examined data for the first study, “Busting Myths about the Impact of Telemedicine Parity,” published Sept. 21 in NEJM Catalyst.

“For patients, the message is clear and reassuring: Telemedicine is an effective and efficient way of receiving many kinds of health care,” Kathleen Fear, PhD, lead author of the first paper, said in a news release. Fear is director of data and analytics at the University of Rochester Health Lab. “Especially for those with transportation challenges, it is a service that really fills a gap – and, vitally, it does not compromise the quality of the care that patients receive.”

It was the first such review with comprehensive data refuting the three myths, Michael Hasselberg, PhD, MS, said in the news release. Hasselberg is URMC’s chief digital health officer and the study’s senior author.

By now it’s no secret that electronic communications with physicians took off during the COVID-19 pandemic, when patients opted to shelter in place at home – or feared contracting the disease at physicians’ offices or hospitals.

The URMC researchers used information about patient demographics, outcomes, provider use, visits completed, and other factors, in times from July to December 2019, from July to December 2020, and from January to June 2021 to analyze three specific concerns about telemedicine:

• That it will reduce access to care for the most vulnerable patients who may be unable to access digital services.
• That reimbursing providers for telemedicine services at the same rate as traditional services will encourage telemedicine overuse.
• That telemedicine is not an effective way to provide care.

Data from more than 3,000 URMC providers showed otherwise, said the researchers.

“We really dug into the data, and it disproved all three concerns, which is really quite exciting,” Fear said. “Not only did our most vulnerable patients not get left behind – they were among those engaging the most with, and benefitting the most from, telemedicine services. We did not see worse outcomes or increased costs, or patients needing an increased amount of in-person follow up. Nor did we find evidence of overuse. This is good care, and it is equitable care for vulnerable populations.”

Physicians and other clinical providers fear they will miss something by not sitting in the room with patients, Fear said, but the URMC researchers found no increase in negative outcomes. The findings don’t mean telemedicine will replace in-person care, but it’s clear it can help people access care, she said.

The second study, “Scaling Supply to Meet Behavioral Health Demand in New York State,” also published in NEJM Catalyst, found a combination of telehealth, on-site visits, and staff education improved access to care and reduced use of antipsychotic medications for nursing home residents.

“At a time when nursing homes nationwide are severely understaffed, and the need for mental health services among their residents is increasing, we’ve efficiently redesigned the way mental health services are provided to the more than 50 nursing homes we work with,” study lead author Adam Simning, MD, PhD, said in the news release. Simning is assistant professor of psychiatry at URMC.