Most physicians have embraced telehealth during the pandemic and expect to continue using it going forward, according to a new survey from the American Medical Association (AMA)—although many note that significant barriers to use remain for both patients and providers.

Physicians' telehealth experiences

For the survey, AMA polled 2,232 physicians between Nov. 1 and Dec. 31, 2021, about their telehealth experiences.

Overall, almost 85% of physicians said they currently use telehealth to care for patients, and nearly 70% said their organization plans to continue using telehealth in the future. Currently, most physicians use either live audio-visual interactive technology or audio-only calls for their telehealth visits with patients, with Zoom and telephones being the most common platforms.

In terms of care processes, physicians reported using telehealth primarily for treatment or therapy (77%), screening or diagnosis (72%), and follow-up care, including for chronic conditions and after surgery or hospitalization (70%). Many physicians also reported offering medication management (72%) and chronic disease management (68%) through telehealth.

According to the survey, most providers measure the value of telehealth through patient satisfaction and access to care metrics. Other important metrics include clinical outcomes and quality, operational efficiency, and effectiveness, and clinician experience.

In the future, many physicians said they planned for their telehealth services to include medical management, chronic disease management, mental/behavioral health care, specialty care, card coordination, and more.

In addition, when asked about why they wanted to continue to provide telehealth in the future, over 80% of physicians said telehealth could help reduce patient barriers to access, as well as unnecessary costs with travel, getting time off, and more. Many physicians also said telehealth has been both clinically and operationally effective.

However, there are barriers to virtual care for both patients and providers that could affect telehealth use in the future.

For patients, physicians identified the digital divide as the biggest barrier to virtual care, with many saying there is limited access to technology and broadband access, as well as limited digital literacy.

"Advancing telehealth without providing patients with the appropriate technology or education to use it, leaves those patients behind and widens the gap," said one physician who was part of the survey.

For providers, physicians identified potential rollbacks of pandemic-era telehealth waivers, coverage, and payment policies; lack of insurer coverage; and low or no reimbursement of telehealth visits as the primary obstacles to virtual care.

Comments

According to AMA president Gerald Harmon, the survey's findings show "adoption of telehealth is widespread as is the demand for continued access."

"Physicians view telehealth as providing quality care to their patients, and policymakers and payers have come to the same conclusion. Patients will benefit immensely from this new era of improved access to care," Harmon said. " ... It is critical that Congress takes action and makes permanent telehealth access for Medicare patients."

Recently, President Joe Biden signed an omnibus spending package that included a provision to extend pandemic-era telehealth waivers for Medicare beneficiaries for at least five months after the national public health ends. The package also allows Medicare to extend coverage of audio-only telehealth services.

This extension will allow Congress more time to study the impact of telehealth expansion under Medicare and decide whether pandemic-era telehealth changes should be made permanent. Currently, the Medicare Payment Advisory Commission is required to release a report on telehealth utilization and costs in Medicare by June 23, 2023, and the Office of the Inspector General is required to submit a report on the program integrity risks associated with Medicare telehealth coverage by the same date. (Adams, Becker's Hospital Review, 3/25; AMA press release, 3/23; Vaidya, mHealthIntelligence, 3/24; Hellmann, Modern Healthcare, 3/8)