Telehealth Does Not Lead to Duplicative In-Person, Finds Epic Research

The surge in the use of telehealth has been one of the unintended consequences of the COVID-19 pandemic. Even with some pulling back from the very high usage in 2020, the shift is clear. What was once a marginal part of the delivery of healthcare in the U.S. has entered the mainstream.

But apprehension that the convenience of telehealth might stoke its overuse, along with evidence of instances of fraud, have sown some doubts about rapid growth in telehealth and whether it needed to be reined in.

Research performed by researchers at Epic, the electronic health records (EHR) company, may allay some of those concerns.

Using data from its Cosmos data set that includes 170 million patients from 180 organizations that use Epic’s EHR, the researchers did not find much evidence that would suggest patients need in-person visits after a telehealth visit.

In-person visits after telehealth visits were common in a handful specialties, notably obstetrics, but that is to be expected, said the researchers

Hands-on care is required in obstetrics, such as listening to the baby’s heart rate, or performing an ultrasound, noted Jackie Gerhart, M.D., one of the researchers, in an email to Managed Healthcare Executive®.

Gerhart also noted that visits can’t be swapped out: “The eight-week visit can’t ‘take the place’ of the 12-week visit, since that is meant to track the baby over time and to cover different prenatal care than what was covered the four weeks prior.”

Gerhart and her colleagues conducted their research by identifying 35 million telehealth visits conducted between March 1, 2020, and May 31, 2022. They also sifted through Epic’s records to see how many of those telehealth visits were followed by in-person visit within 90 days by a provider in the same specialty.

Among the 33 specialties, genetics (4%), nutrition (10%) and endocrinology (14%) had the lowest percentage of in-person visits that occurred within 90 days of the telehealth visits. Obstetrics (92%), fertility (54%) and geriatrics (50%) had the highest.

Here is a chart that the was published with the Epic research to illustrate the findings:

Epic research has not been published in a peer-viewed journal. However, Epic says two teams of its researchers worked independently and came to similar conclusions.

“These findings suggest that, for many specialties, telehealth visits are typically an efficient use of resource and are unlikely to require in-person follow-up care,” said the Epic news release about the research.

Telehealth cannot replace in-person appointments that require physical observations or hands-on care, noted Gerhart in her email to MHE, giving obstetrics and surgery as examples.