New research by Epic Research reveals that in-person follow-up rates are higher for most specialty care-related office visits compared to telehealth visits, including mental healthcare. The study analyzed data from over 190 million patients across 208 healthcare organizations. In-person follow-up rates were highest for mental health, physical medicine and rehabilitation, and pain medicine office visits. However, certain specialties like podiatry, obstetrics, gynecology, and ophthalmology showed higher rates of in-person follow-up after telehealth visits. The findings contribute to our understanding of telehealth’s impact on healthcare utilization.
New research conducted by Epic Research reveals that in-person follow-up rates for most specialty care-related office visits are higher than for virtual visits, including mental healthcare.
The study analyzed data from Cosmos, a HIPAA-defined limited dataset, consisting of over 190 million patients from 208 healthcare organizations across the United States and Lebanon, who used the Epic EHR system. The researchers examined 40.68 million specialty visits and 32.14 million primary care encounters between January 2022 and March 2023. Specialties with fewer than 400,000 encounters during the study period were not included.
The findings indicate that within 16 out of the 24 specialties studied, in-person follow-ups occurred more frequently within 90 days after an office visit compared to telehealth visits.
In comparison to telehealth, mental health-related office visits exhibited the highest rates of in-person follow-up, followed by physical medicine and rehabilitation and pain medicine-related visits. The rate of in-person follow-up for mental health office visits was 40.3 percent, while mental health-related telehealth visits had a significantly lower rate of 9.8 percent.
For physical medicine and rehabilitation office visits, the in-person follow-up rate was 24 percent higher than that of telehealth visits. Similarly, pain medicine office visits had a 20.5 percent higher rate of in-person follow-up compared to telehealth visits.
On the other hand, podiatry, obstetrics and gynecology, and ophthalmology demonstrated higher rates of in-person follow-up after telehealth visits compared to office visits. Podiatry had a 12.6 percent higher in-person follow-up rate for telehealth visits, while obstetrics and gynecology, as well as ophthalmology, had rates of 9.2 and 9.1 percent higher, respectively.
Certain specialties, including allergy and immunology, dermatology, and ENT, also exhibited slightly higher rates of in-person follow-up after telehealth visits compared to office visits.
In the realm of primary care, the difference in in-person follow-up rates between telehealth and in-office care was relatively minor. Internal medicine telehealth visits had a 2.1 percent higher rate of in-person follow-up than office visits, while pediatric telehealth visits had a 0.8 percent higher rate. Conversely, family medicine office visits had a 0.2 percent higher rate of in-person follow-up compared to telehealth visits.
These recent findings contribute to our understanding of telehealth’s impact on healthcare utilization, an area of growing research given the continued popularity of telehealth. Previous studies conducted by Epic Research have also examined in-person follow-up rates for primary care and specialty care-related telehealth visits.
One study published in December 2022 analyzed 35 million telehealth visits between March 1, 2020, and May 31, 2022. It revealed that in nearly all specialties, the majority of telehealth patients did not require an in-person follow-up appointment within three months following the virtual visit. The specialties with the lowest rates of in-person follow-up appointments were genetics, nutrition, and endocrinology, while obstetrics and virtual fertility had the highest rates, with 92 percent and 54 percent of patients, respectively, requiring an in-person visit three months after a telehealth appointment.
Another study published in March examined 18.6 million telehealth visits for primary care between March 1, 2020, and October 15, 2022. It found that 61 percent of primary care telehealth visits did not necessitate an in-person follow-up within three months in the same primary care specialty. Pediatric primary care visits were more likely to require an in-person visit after a telehealth appointment.
Furthermore, a study from May revealed that patients who had an initial telehealth visit were just as likely to require emergency department (ED) follow-up visits as those who received in-person care, except for cases related to respiratory infection, bronchitis, and pharyngitis. The study analyzed data from 40 million privately insured patients under 65 years old, collected from July to December 2020. Within 14 days of the initial visit, unplanned hospitalizations and follow-up ED visit rates were similar for in-person and telehealth visits for 18 out of 21 conditions assessed.
