Survey: Clinicians' perceptions of telehealth vary based on specialty

A recent survey of clinicians revealed specialty-specific differences in telehealth perceptions, with mental health clinicians rating video-based care higher than those in primary and specialty care.

Researchers also found an association between how physicians perceive telehealth and rates of utilization because those with higher rates of use reported more positive perceptions of the practice.

Samantha Connolly, PhD, an assistant professor at Harvard and investigator for the United States Department of Veterans Affair’s Center for Healthcare Organization and Implementation, and colleagues conducted the survey of 814 clinicians to analyze if perceptions of telehealth quality were associated with use. The researchers divided telehealth into phone or video appointments.

Of the respondents, 403 were mental health clinicians, 258 were in specialty care and 153 were in primary care. Across all groups, mental health clinicians provided the most telehealth care; specialty care clinicians had the highest proportion of in-person care; and primary care clinicians had the highest proportion of phone visits. Primary care and specialty care clinicians had “multiple similarities in their responses across the survey,” according to the researchers.

Mental health clinicians conducted many more of their appointments via video — around 40.3%. In comparison, video care accounted for 4.9% of specialty care visits and 3.9% of primary care visits. Mental health clinicians also rated quality of video care the highest and were found to be more likely to prefer video care (73.9%) rather than care over the phone. Most primary care and specialty care clinicians, on the other hand, either preferred the phone over video when providing remote care (28.3% and 32.2%, respectively) or had no preference (36.2% and 28.4%, respectively) when it came to established patients.

“This finding underscores the importance of complexity in influencing adoption of new technologies; if [primary care] clinicians believe that phone and video care are equivalent in quality, ease of use may then drive the choice of phone over video, particularly when treating patients whom they have already seen in-person,” the researchers wrote.

There are several possible reasons for the differences: primary care and specialty care clinicians reported challenges in video care, “including patient barriers and the inability to conduct a physical examination,” the researchers wrote.

“There is a need for additional data regarding the relative effectiveness of video and phone telehealth as well as improved processes to better integrate video telehealth into clinician workflows,” Connolly and colleagues wrote. “Such advances will be critical in influencing clinician attitudes and ensuring the provision of high-quality care at the right place and the right time.”