Most primary care patients do not have in-person follow-up after telehealth visit

More than 60% of patients who had a primary care telehealth visit did not have an in-person follow-up visit for at least 3 months, although children more often required a follow-up visit, according to a recent report.

“Physicians who have been evaluating how or whether to continue or expand their telehealth services can use these findings to understand how telehealth might influence their overall capacity and availability for patient appointments, as well as potentially increasing access to care for their patients,” Danessa Sandmann, the head of operations at Epic Research, a medical software development company, told Healio.

For the study, Jackie Gerhart, MD, FAAFP, a clinical informaticist at Epic Research, and colleagues analyzed data from 18,636,522 telehealth visits that were conducted between March 1, 2020, to Oct. 15, 2022.

“Previously, we reported that patients who had a specialty telehealth appointment often did not require an in-person follow-up appointment within the next three months,” Gerhart and colleagues wrote. “We explored whether that same finding holds in the specialties of family medicine, general internal medicine and pediatric primary care.”

Among all primary care subspecialties combined, 61% of patients did not need an in-person follow-up visit within 90 days after their telehealth visit. Specifically, 63% of internal medicine patients, 60% of family medicine patients and 54% of general pediatrics patients did not need a follow-up visit.

“General pediatrics was the most common primary care specialty to need in-person follow-up, but patients still had in-person follow-up less than half of the time,” Gerhart and colleagues wrote.

The researchers also examined insurance coverage factors. Seventy-six percent of self-paying individuals did not need in-person follow-up visits compared with 55% of those with Medicare, 55% of those with Medicaid and 63% of those with any other type of insurance.

While the rate of telehealth visits in primary care was lower compared with other specialties, Gerhart and colleagues noted that the high rate of no follow-up visits may have been an underestimation.

“Primary care physicians treat a wide variety of conditions, so the subsequent in-person visit might not have been related to the reason for the telehealth visit,” Gerhart and colleagues wrote. “For example, a telehealth visit for an upper respiratory infection wouldn’t affect whether a patient has a normal wellness exam scheduled in the next 3 months, yet in our study that would be counted as having had in-person follow-up.”

Sandmann that future research “can help optimize patient experience and patient outcomes by continuing to explore what care delivery methods.”

“This will help to increase opportunities for patients to get the care they need, when they need it, in the way that makes the most sense for them and their health,” she said.