A new study concludes that common concerns regarding telemedicine are unfounded, and it highlights how effective digital health is at providing access to quality care for all. The study is one of two telehealth studies conducted by researchers from the University of Rochester Medical Center (URMC) that were recently published in the NEJM Catalyst. The second paper shows how successful URMC’s efforts were at providing mental health care to nursing homes using a hybrid approach that includes telehealth.
According to Kathleen Fear, Assistant Professor in the School of Nursing, Director of Data & Analytics at the UR Health Lab, and lead author of the first study, the research shows that telemedicine is a valuable service that fills a void, especially for patients who face transportation challenges. More importantly, it provides patients with an efficient and effective method of accessing healthcare without compromising on the quality of the care they receive.
Increased Availability of Telehealth Does Not Lead to Abuse
For the study, titled “Busting Myths about the Impact of Telemedicine Parity,” Fear and her colleagues analyzed data collected during the COVID pandemic, when many health care institutions across the country quickly expanded their telehealth services, to answer three primary questions and concerns regarding the use of telemedicine:
– Would telehealth decrease access to healthcare for vulnerable patients who may not have access to web connected devices such?
– Would reimbursing healthcare providers for telehealth services at the same rate as in-person healthcare services lead to the misuse of the modality?
– Is telemedicine a less efficient or high-quality means of providing healthcare?
Fear says that while the above three concerns about telemedicine are common, their data analysis disproved them all. According to Fear, their most vulnerable patients was amongst those who engaged with and benefitted from telehealth services the most. Additionally, researchers didn’t see health outcomes worsen or costs increase, or the need for more in-person follow-up visits in patients who made use of telemedicine. There was also no evidence that telehealth was used excessively. The study concludes that telehealth offers good care and provides equitable access to high quality care for vulnerable patients.
According to senior author, Michael Hasselberg, an associate professor in nursing and mental health and chief digital health officer at URMC, the study is the first to publish comprehensive data that refutes these three common myths, which have restricted acceptance of telemedicine by insurance providers. Researchers from URMC were uniquely positioned to conduct the study due to the work of over 3,000 healthcare providers from a broad swath of the health system who make use of telemedicine, together with the UR Health Lab’s ability to analyze data collected during the course of their work.
For the study, the URMC researchers compared data collected between July-December 2020—a relatively normal period after the initial COVID-19 surge, to data collected between July-December 2019, before the pandemic struck, using data collected between January-June 2021 as the follow-up period. The study’s analysis included an assessment of patient demographics, health outcomes, health provider use, and number of visits completed, among other statistics.
“For our providers, a major concern about telemedicine has always been, ‘What might I miss if I can’t sit in the room with the patient?’” said Fear. “But we simply didn’t find any increase in negative outcomes. This doesn’t mean telemedicine will replace in-person care, but it’s clear that it can help people access care more consistently and comfortably and that it provides a highly effective complement to traditional care.”
Telehealth Improves Access to Mental Healthcare for Nursing Home Residents
The second URMC study published in NEJM Catalyst, titled “Scaling Supply to Meet Behavioral Health Demand in New York State Nursing Homes,” assessed the effectiveness of a program developed by URMC physicians to offer mental health services to patients in nursing homes using a combination of telehealth, on-site consultations and staff education. The results of the study show the program helped to improve access to mental health care services and reduced the number of nursing home residents needing anti-psychotic medication.
According to Adam Simning, an Assistant Professor of Psychiatry specializing in geriatric psychiatry and lead author of the study, the small team of dedicated URMC clinicians have had a huge reach, bringing mental healthcare to patients residing in regions where access to good quality mental healthcare services is limited at best. Currently, nursing homes countrywide are extremely short-staffed, and there is a growing need for mental health services for residents. According to Simning, the URMC team have identified a way to deliver crucial mental health services to the more than 50 of the elder care facilities they collaborate with.
Hasselberg, who was also a senior author on the second paper, believes both studies will resonate with the medical community, encouraging policymakers and payers to maintain and expand COVID-era policies that support the growth and reach of telehealth services. “Hopefully, what we’ve learned here will help the rest of the country and help shape the future of health care as telemedicine becomes increasingly prominent,” said Hasselberg.