92% of allergy/immunology practices now use telehealth
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The use of telehealth expanded in allergy and immunology care due to the COVID-19 pandemic, with 92% of practices providing such services, according to a survey from the AMA and American College of Allergy, Asthma & Immunology.
“We wanted to better understand clinician attitudes toward telehealth post-pandemic, whether there was sustained adoption, and where there are opportunities for further training and education,” Tania Elliott, MD, FAAAI, FACAAI, chair of the ACAAI Telehealth Task Force, told Healio.
According to Elliott, who also is chief medical officer of virtual care at Ascension, the advantages of telehealth include access, higher visit adherence, patient and provider satisfaction and longitudinal care delivery. But its disadvantages include a lack of awareness of telehealth resources and education for practices and patients, as well as a lack of consistent technology experience for patients.
The organizations collaborated on an online survey of 136 allergists and immunologists (58% male; 57% white) conducted between Nov. 1 and Dec. 31, 2021. Although providers remain committed to offering telehealth services, the ACAAI found that barriers to its use remain.
The respondent population was 61% suburban and 52% from single-specialty offices.
Among those practices using telehealth, 97% conduct live audiovisual interactive telehealth visits, 59% use telephone or audio only calls and 16% use asynchronous telehealth, where clinical information is collected, stored and sent to another site for evaluation.
Elliott said she expects the technology to expand beyond synchronous visits to include more remote patient monitoring and asynchronous interactions.
Nearly one out of every five patient visits are conducted via telehealth, the ACAAI continued, with 68% of respondents reporting that more than 75% of these visits are conducted with established patients.
Providers report using telehealth for:
- treatment or therapy (83%);
- screening, assessments or diagnosis (78%);
- follow-up care including chronic care and post-hospitalization (76%);
- continuous monitoring (58%); and
- intake or triage (42%).
As far as popular telehealth platforms, 38% of respondents used Doxy.me, 33% used audio-only telephone visits, 32% used Doximity Video, 25% used Zoom, 20% used electronic health record telehealth modules and 30% used FaceTime.
Providers reported a positive attitude toward telehealth too, with 70% saying that the technology has given patients better access to care, and half believing that patients are more satisfied with care. Similarly, 50% said telehealth enables them to provide high-quality care, although 29% disagreed and 20% were neutral.
Access to technology, digital literacy and a preference for in-person visits were the top three perceived patient barriers to using telehealth. Among providers, lack of insurance coverage and uncertain payer reimbursement represented the top barriers to implementation and continuation of services.
Also, ACAAI found that that awareness of telehealth research or best practices among providers was low and that resources and information could be better disseminated, while additional research to support telehealth is needed as well.
Elliott said that ACAAI will support telehealth via training and educational resources, practice management resources specific to hybrid care and case studies highlighting successful programs including artificial intelligence.
Reference:
- 2021 National telehealth survey report – allergy/immunology. https://college.acaai.org/wp-content/uploads/2022/05/Allergy-and-Immunology-Telehealth-Survey-Report-2021-Final.pdf. Posted May 16, 2022. Accessed May 16, 2022.
For more information:
Tania Elliott, MD, FAAAAI, FACAAI, can be reached at tania.elliott@nyulangone.org.
Perspective
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These results are no surprise to me. Doctors and patients love telehealth. We just want to be paid fairly for our work. Insurance companies and the government view these as “extra” visits. In truth, telemedicine visits replace in-person visits in many cases.
Prior to COVID-19, we did no telehealth in my practice. But we rapidly pivoted so we could serve our patients during the pandemic. Now that things are returning to normal, we still virtually see patients who have difficulty getting to the office as a supplement to in-person care.
Patients love it. Telehealth offers an option that was not there before the pandemic. There’s no question, however, that the burdensome rules and regulations of the federal government dictate coverage and payment. These rules established by Congress have been waived during the public health emergency, but when it ends, 151 days later, telehealth could vanish for most of us. Only Congress can change this.
I led a delegation of ACAAI leaders to Washington, D.C., this month, partnering with patients from the Allergy & Asthma Network, to plead with our leaders to act to allow access to telehealth to continue. Among these problematic rules, patients must live in a rural area or travel to a designated telehealth site.
Because broadband is so poor in much of the country, we asked for parity in payment between phone-only visits. We also asked that telehealth be paid at the same rates as in-person visits. There are dozens of such requirements that need to be changed by Congress if telehealth is to remain a practical option.
The biggest barriers to telehealth for patients include lack of adequate broadband. For patients more than 10 miles from my office, broadband will not support audio-visual virtual visits.
How telehealth will evolve all depends on if Congress changes the laws. While I believe the public health emergency has given doctors and patients a great test of the telehealth model, it cannot evolve to be fully incorporated into practice unless Congress acts.
Doctors are not looking to replace all in-person visits with telehealth. We still need the personal touch and the trust that develops in person. But for many situations, accessible and properly compensated telehealth is a much needed alternative.
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