Study finds telehealth expands access to health care


WASHINGTON — As the interest in telemedicine programs continues to grow, a recent Rand study found that people who are younger, more affluent and do not have established healthcare relationships are more likely to use a telemedicine program that allows patients to get medical help for acute ailments — including prescriptions — by talking to a doctor over the telephone.

Patients who used the service suffered from a wide assortment of acute medical problems, such as respiratory illnesses and skin problems, and researchers indicated that they found little evidence of misdiagnosis or treatment failure among those who used the service.

The findings, published in the February edition of the journal Health Affairs, are from the first assessment of a telemedicine program offered to a large, diverse group of patients across the United States.

"Telemedicine services such as the one we studied that directly links physicians and patients via telephone or Internet have the potential to expand access to care and lower costs," Lori Uscher-Pines, lead author of the study and a policy researcher at Rand, a nonprofit research organization, stated. "However, little is known about how these services are being used and whether they provide good quality care. Our study provides a first step to better understand this growing health care trend."

Uscher-Pines and co-author Ateev Mehrotra studied 3,701 patient "visits" provided from April 2012 to February 2013 by Teladoc, a provider of telemedicine services. Teladoc connects patients to providers for specialty visits or connects providers to other providers for consults for in-hospital care. Patients who used Teladoc were compared to peers who visited hospital emergency departments or a doctor's office for a similar problem.

Among patients studied, the most common problems for a Teladoc visit were acute respiratory conditions, urinary tract infections and skin problems, which accounted for more than half the cases. Other frequent reasons for Teladoc visits were abdominal pain, back and joint problems, viral illnesses, eye problems and ear infections.

Teladoc users were slightly more likely to be women and live in more affluent areas. In addition, more than a third of Teladoc visits occurred on weekends or holidays.

"The people who are attracted to this type of telemedicine may be a more technologically savvy group that has less time to obtain medical care through traditional settings," Mehrotra, a Rand researcher and an associate professor at the Harvard Medical School, said.

Across the leading conditions, visits to Teladoc were less likely than visits to the emergency department or a physician office to result in a follow-up visit for a similar condition, according to researchers. Rand researchers have indicated that the finding suggests that health problems were most likely adequately addressed during the Teladoc visits. However, researchers caution that more research is necessary to further assess the quality and safety of telemedicine services.

Support for the study was provided by the California HealthCare Foundation.


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