Telemedicine Leads to Fewer Follow-Up Visits When Compared to In-Person Visits

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Recently, Epic published research that found that telehealth patients are often less likely to attend follow-up visits, when compared to in-person visits. The research was done to complement two studies that previously showed most telehealth appointments did not require an in-person follow-up appointment in the next 90 days, and compared how follow-up rates differ for in-person visits versus telehealth visits.

To perform the research, the authors studied more than 40 million specialty and 32 million primary care encounters from January 2022 to March 2023, excluding specialties with fewer than 300,000 encounters during the study period. Of 24 specialties evaluated, authors found that 16 had in-person follow-up after an office visit more often than after a telemedicine visit, especially mental health (30.8%), physical medicine and rehabilitation (24%), and pain medicine (20.5%). The six specialties that had more follow-ups after telehealth visits were: podiatry, OB/GYN, ophthalmology, ENT, dermatology, and allergy/immunology.

Follow-up rates for telehealth and office visits in primary care were within two percentage points of each other, with pediatrics and internal medicine slightly more likely to have follow-up after telehealth visits, 0.8% and 2.1%, respectively. Family medicine also saw nearly equivalent follow-up rates (0.2% more follow-ups after in-person visits) between telehealth and office visits with in-person follow-up within 90 days.

When expanding the analysis to include any type of follow-up (telemedicine or in-person), there were greater rates of follow-up after office visits for most specialties. However, even in that instance, all types of primary care had a slightly higher follow-up rate after telehealth.

The authors noted that telehealth use in 2022 and early 2023 was not frequent for most specialties, with only sleep medicine and mental health conducting at least 20% of encounters using telemedicine. However, they concluded that telehealth “can continue to play an important role in care delivery across specialties without requiring additional visits for many patients.” They further noted that there may also be differences in the patient populations that seek care through telemedicine when compared to in-person visits, including age and acuity of their condition, that may influence the likelihood of follow-up care actually medically needed for the patient.

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