What are small practices saying about telemedicine?

Editor's Note: Welcome to Medical Economics' blog section which features contributions from members of the medical community. These blogs are an opportunity for bloggers to engage with readers about a topic that is top of mind, whether it is practice management, experiences with patients, the industry, medicine in general, or healthcare reform. The series continues with this blog by Jake DiBattista, a territory manager at SimpleVisit, a video service provider for physicians. The views expressed in these blogs are those of their respective contributors and do not represent the views of Medical Economics or UBM Medica.

Jake DiBattistaWhile leaders in healthcare are pushing for an era of digital care, many providers on the frontlines have remained silent observers.

Further reading: Why aren't more doctors using patient engagement tools?

In a recent field survey¹, my team explored the impact of telemedicine in four types of small practices located across the U.S. The survey was distributed among practice types that were identified as highly likely to be using telemedicine services: primary care, house-call only and concierge-care doctors.

Phone interviews of staff and practitioners were conducted to dig into the rate of usage, and to discover which patient demographic benefitted the most from telehealth. All practices interviewed were independent practitioners in a practice of 10 or fewer total providers.

Family Practice

The first provider segment interviewed were family practitioners, who have been viewed by many as a champion of telehealth and the first layer of healthcare for most patients. Telehealth feels like a natural fit for family practitioners, who must screen patients quickly and make a variety of diagnoses.

More from Jake: Navigating the buzzwords of telehealth

It was discovered that a majority of generalists interviewed view telehealth as a key asset for elderly care. However, despite a clearly identified need, less than 20% of providers interviewed currently offered their patients video visit services. While a minority did offer telemedicine services such as phone calls, texting, emailing and e-prescribing, willingness to try video visits was limited.

House Call Only

The second category analyzed was providers who primarily offer house-call services to patients. A fleeting concept, the house call was once the dominant mechanism of healthcare delivery in America.

Next: There seems to be a disconnect

Considering the new age house call, telemedicine appears to be a natural fit for providers who stand behind convenient care. Surprisingly, house-call doctors had one of the lowest rates of adoption amongst the provider types surveyed.

In case you missed it: Telemedicine up for heated debate

When questioned about why they would not adopt telemedicine technology, the most common answer was “I don’t find video visits as capable of doing everything I need for my patients during a visit”. While some cases did require special attention, over 80% of house call providers said that homebound elderly patients receiving routine maintenance would benefit from telemedicine technology.

There appears to be a likely disconnect between the limitations of telemedicine and the services patients in this segment are in need of during a visit.

Concierge Care

Reimbursement is often indicated as a major barrier to telemedicine implementation. With this in mind, we wanted to study how concierge, or capitation and cash based practices are utilizing telehealth.

Rates of interest in telemedicine utilization did not fall outside the expected range in comparison to all other practice types. Many concierge practices indicated small patient bases who expected a high level of quality in their care as the biggest barrier to engaging in telehealth.

More than 50% of the practices that we interviewed identified that few of their patients would benefit from virtual care, and utilization among practices engaging in telehealth was extremely rare.

Related: Virtual visits boost primary care outcomes

The perception of reduced quality of care, as a result of video visits, seems to be a common misconception amongst practice types who choose to operate outside the conventional practice style of high-visit volumes with insurance reimbursement.

Next: Concluding thoughts

Conclusion

Based on the results of the field study, there remains surprisingly low adoption rates regardless of the type of practice, even though 75% of doctors recognize that a portion of their patient base would benefit from telemedicine. Yet, the same group reported about 17% in current implementation.

Further reading: Top 7 reasons physicians should consider telemedicine

The patient segment most often identified as benefiting from telehealth was elderly patients who struggle to make it in for regular appointments. Perhaps the rise in telehealth is coming for small practice providers, but we are still in the early phases of this adoption.

1. The study, conducted by SimpleVisit, had a 24% respondent rate from a pool of 100 physicians-6 were generalists, 6 were psych, 6 were concierge, and 6 were house call.