Even with the substantial growth in telemedicine usage, these tools are not reaching new demographic groups in large numbers. (Photo: fizkes/Shutterstock.com)
The growth of telemedicine is one of the top benefits stories to come out of the 2020 COVID-19 pandemic. And increasingly, researchers are getting a handle on just how much the use of telemedicine has expanded, what patients and areas of care have most been affected, and where digital gaps still remain. A new report from Rock Health and Stanford Medicine puts the new trend toward telemedicine in better focus, and suggests some challenges still remain for this evolving delivery system.
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The Digital Health Consumer Adoption Report 2020 compared consumer behavior around digital health during last year's pandemic to data from the prior five years. The researchers noted that use of digital health tools had been climbing steadily but telemedicine visits were still just a fraction of overall health visits before 2020. With the onset of the COVID-19 pandemic, there was a sudden acceleration in the adoption of digital health. But the study found that the use of digital tools has remained uneven—for example, younger health care consumers are more likely to use these tools, as compared with older patients.
"Though not a universal finding, some of the 2020 data suggest that the pandemic acted more to reinforce and accelerate underlying trends rather than to draw in new consumer subgroups as digital health users," the researchers wrote. They add that current trends suggest that a digital health use will continue at levels lower than what was seen during the peak of the pandemic, but higher than pre-pandemic levels.
After the flood, a steady rate of utilization
In a manner of speaking, the dam burst when it came to telemedicine usage in the early months of 2020. With the pandemic spiking across the US in March, in-person health appointments saw a sharp drop, and telemedicine was seen as a way to diagnose and treat patients, although it had some limitations. By April, the report showed, telemedicine visits were up to 14 percent of baseline visits—compared to the average pre-pandemic level of 0.1%.
This higher level of usage moderated as spring turned into summer. By June, telemedicine usage evened out at about 7%-8% and stayed there for months; levels were at around 6% in October.
However, the new study found that even with the substantial growth in telemedicine usage, these tools are not reaching new demographic groups in large numbers. "The most likely users of telemedicine in 2020 remained consistent with past years," the report said, adding that users tend to be: "Higher income earners, middle-aged adults (aged 35-54), highly educated, and those with chronic conditions." The study said lower rates of adoption were seen among consumers from rural areas, older consumers, and those with lower incomes.
Usage also varies depending on the type of telemedicine tools. More consumers used live video telemedicine, fewer used non-video forms, the data from 2020 showed. Tools such as live phone visits, text messaging, and email actually went down as the big increase in video visits took place. "A driving factor in the year-over-year reduction in non-video telemedicine may be the reduction in health care utilization across the board," the study noted. "Consumers used substantially less health care overall (both in person and via telemedicine)."
Issues with adoption of telemedicine remain
Despite the high profile of telemedicine in 2020, the report noted that barriers remain. Although patients generally reported high satisfaction with telemedicine, the report said that this may be due to relief of finding an avenue of care during a stressful time. "During 2020, the most common channel [of telemedicine] was through a patient's own doctor/clinician," the report said. "We see these as COVID-19-necessitated behaviors, but they are not the contours of how we envision telemedicine best serving patients in the future, when tech-enabled care models are proactive, continuous, and outcomes-oriented."
Concerns about data sharing also continues to be an issue. As with previous studies, this report found that patients' willingness to share data depended on who the data is being shared with. For example, patents said they were most willing to share COVID-19 test results with their doctor, family, and health insurer. But they were not as willing to share personal data with entities building health care solutions—a possible barrier in the development of future digital health tools.
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