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Annals of Internal MedicineTelemedicine Versus In-Person Primary Care: Treatment and Follow-up Visits

Telemedicine Visits Lead to Higher Rates of In-Person Return Visits, Varying by Clinical Condition

In a recent study, researchers sought to understand the effectiveness of telemedicine in primary care settings by comparing treatment and follow-up visits between primary care video or telephone telemedicine and in-person office visits. The findings provide valuable insights into the use and outcomes of telemedicine.

Study Design

  • The study used a retrospective design based on administrative and electronic health record (EHR) data.
  • It was conducted in a large, integrated health care delivery system with more than 1,300 primary care providers, between April 2021 and December 2021 (including the COVID-19 pandemic Delta wave).
  • The study involved 1,589,014 adult patients; 26.5% were aged 65 years or older, 54.9% were female, and 31.8% had a chronic health condition.

Key Findings

  • Of the 2,357,598 primary care visits studied, 50.8% used telemedicine (19.5% video and 31.3% telephone).
  • After adjustment, medications were prescribed in 46.8% of office visits, 38.4% of video visits, and 34.6% of telephone visits.
  • After the visit, 1.3% of in-person visits, 6.2% of video visits, and 7.6% of telephone visits had a 7-day return in-person primary care visit.
  • Differences in follow-up office visits were largest after index office versus telephone visits for acute pain conditions and smallest for mental health.

In summary, the study found that telemedicine visits led to somewhat higher rates of in-person return visits compared to in-person primary care visits. However, these rates varied depending on the specific clinical condition addressed during the visit. This raises the question: How can telemedicine be optimized to reduce the need for follow-up in-person visits?

According to a report by McKinsey & Company, telehealth utilization has stabilized at levels 38 times higher than before the pandemic.

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