BACKGROUND: Telehealth is a healthcare delivery platform that allows for clinicians to deliver care via the phone or computer. The public health restrictions associated with the Covid-19 pandemic have shown how telehealth could be used as a platform to deliver care. With state-wide stay at home orders and the associated suspension of elective medical procedures telehealth rose as an option to deliver care to patients. Prior authors described that telehealth usage increased at the start of the pandemic and then decreased once the reopening processes in several states commenced in the May to June period. Although these studies have provided valuable information regarding telehealth, many of these did not look beyond the June time frame. In addition, the implications from the range of telehealth policies remain largely unexplored.
OBJECTIVE: We sought to assess policies and other drivers of telehealth use. In order to achieve this, we described the change in telehealth usage over the year of 2020, identified potential drivers of increased telehealth usage at the patient and policy level, and explored the heterogeneity of state policies.
METHODS: We performed a retrospective cohort study of 417,963 de-identified individuals with healthcare visits between December 2019 to December 2020. This data was extracted from HealthJump, which contains Electronic Health Record data sourced from participating members of its network. Visits were labeled telehealth by using CPT billing codes. We explored national and state-level trends in telehealth use, as well as patient-level drivers such as demographics, medical diagnoses, and Covid-19 status.
RESULTS: Telehealth usage increased at the onset of the pandemic across the nation, different age groups, and various health diagnoses. The relaxation of state policies led to a decrease in telehealth usage across the nation and individual states but was higher than pre-pandemic conditions. Telehealth was used more by those with conditions deemed “at-high-risk” for Covid-19 as well as medical specialties that were more feasible for the virtual platform. Patients who were Covid-19 positive used telehealth more in the latter part of the year. Patients who were 65 and older did use telehealth, even though it was at a lower volume than the other age group (under 65).
CONCLUSION: The Covid-19 pandemic has shown how telehealth can be an effective alternative to in-person visits for medical needs that are elective or non-life-threatening. Although telehealth may not be used in the same capacity as it was during Covid-19, the results show that people are willing to use it and that looking into the future Telehealth can be implemented into the healthcare system.
| Identifer | oai:union.ndltd.org:bu.edu/oai:open.bu.edu:2144/42866 |
| Date | 11 August 2021 |
| Creators | Punnamaraju, Atulita G. |
| Contributors | Garrido, Melissa, Stevens, Jennifer P. |
| Source Sets | Boston University |
| Language | en_US |
| Detected Language | English |
| Type | Thesis/Dissertation |
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