What began as an emergency stop-gap measure during Covid has settled in and become an established part of normal, everyday medical care. While virtual care over the telephone was relatively rare in the years (decades) prior to Covid, doctors began to consult online with patients almost overnight. Few patients wanted to risk catching Covid by congregating with other patients in a physician’s waiting room. Few doctors wanted to risk treating contagious Covid patients through in-person exams. A recent study found telemedicine has become an established practice across the University of Pennsylvania Health System:
New research now shows that telemedicine did not fade once clinics reopened. Instead, virtual doctor visits settled into a steady role in the health system, offering convenience for many patients while still leaving some groups behind.
The findings suggest telemedicine is no longer a temporary workaround. It has become a permanent layer of modern healthcare – but who actually benefits from that convenience remains uneven.
Researchers analyzed 46 million patient visits across the University of Pennsylvania Health System. They found that once Covid let up virtual visits remained steady. While some people return to in-office visits, many did not. Researchers also found some variation among those who returned to in-office visits compared to those who preferred virtual telemedicine visits. The patients who had most to gain from telemedicine appeared to be the least likely to use it:
Age produced the steepest divide in virtual care, with adults 65 and older trailing far behind younger patients.
In the Penn Medicine records, older adults were more than 50 percent less likely to use telemedicine. Studies suggest several reasons for that gap, including difficulty navigating platforms, hearing challenges, language barriers, and discomfort with video visits.
Race was also a factor in who preferred in-office care versus who had physician consults over the Internet.
Race also shaped who used virtual care once telemedicine settled into routine practice. Compared with White patients, telemedicine use was 18 percent lower for Asian patients, 12 percent lower for Black patients, and six percent lower for Hispanic patients.
Income also played a role but not necessarily in the way one would think:
Income told a more complicated story because patients in lower-income neighborhoods were about six percent more likely to go virtual.
Of course, convenience and distance also determined to some degree who came into the office compared to patients who preferred virtual visits:
People living more than 15 miles from care were 42 percent more likely to use telemedicine than those nearby. Long drives raise the hidden price of care, as fuel, parking, work hours, and child care can quickly add up.
Researchers also found those patients already familiar with the health system’s online tools were more likely to use telemedicine.
Patients already active on a patient portal were 44 percent more likely to choose virtual visits.
Because portals handle messages, test results, and appointments, they also teach the logins and clicks telemedicine requires.
That pattern suggests digital comfort can build on itself – and that health systems hoping to expand virtual care may first need to help patients learn the technology.
Finally, some conditions lend themselves to telemedicine more than others. Primary care was the most likely to migrate to virtual visits, while specialties were less so. Initial patient visits are generally conducted in the office. Whether a patient has the opportunity for a virtual visit is often at the discretion of their doctor. Some physicians were also more comfortable with virtual care than others. The future of telemedicine will also depend on technology that is easier to use, more refined clinical workflows and procedures designed to reach those who currently feel less comfortable with telemedicine.
Read more at: Virtual doctor visits are here to stay in modern healthcare