Rural family physicians more likely to use telehealth

Telehealth is quickly becoming a staple in most medical practices, yet family physicians remain understudied in the use of telehealth in their practices. Researchers conducted a national survey of family physicians to determine use and barriers of remote monitoring services.

The findings, published in the May/June issue of Journal of the American Board of Family Medicine, were drawn from 1,557 surveys, 15 percent of which reported the use of telehealth services in 2014.

“As telehealth technological capabilities improve and the demand for accessible health care services increases, telehealth represents an important venue to meet the needs of patients,” wrote Miranda A. Moore, PhD, first author on the study and colleagues. “Few previous studies have examined the use of telehealth in primary care settings. To our knowledge, our study represents the first in-depth assessment of these issues using a nationally representative sample. As the largest health care delivery platform in the United States, the primary care setting offers great potential for expanding telehealth use.”

When compared to non-telehealth users, telehealth users were:

• 26 percent more likely to be located in a rural setting.
• 97 percent more likely to use an electronic health record.
• 40 percent more likely to work in a practice with less than six family physicians.
• 22 percent less likely to work in a privately-owned practice.
• 76 percent less likely to provide general primary care to patients.

Additional findings included:

• Family physicians used telehealth infrequently, with 22 percent using it once or twice in 2014 and 26 percent using it three to five times.
• 31 percent used store-and-forward image of test transmission.
• 11 percent used shared computer screen images with audio.
• 55 percent of family physicians used telehealth for diagnosis and/or treatment purposes.
• Other uses included chronic disease management, follow-up, second opinions and emergency care.
• 68 percent of family physicians used telehealth to refer patients to specialists.
• 28 percent used telehealth to refer patients to mental health providers.
• Top barriers for both telehealth users and nonusers were lack of training and reimbursement.

“If telehealth services are to have a major impact in the primary care setting, more physicians will need to become experienced in the use of these services,” concluded Moore and colleagues. “Many impediments to wider adoption exist; however, many of these barriers are amenable to policy modifications. One suggestion for overcoming the training barrier is for family medicine residency programs to ensure that graduating residents are offered opportunities to use telehealth services. To address issues of reimbursement, governmental and private payers could engage in outreach efforts to increase awareness of their current allowed payments for telehealth and either expand the types of telehealth services currently eligible for payment or develop new ways to reimburse telehealth services."