Telehealth Use Varies Widely by Condition, Study Finds
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A new study published in JAMA Network Open offers critical insights into how the diagnosis at hand influences whether a primary care visit is conducted in person, by phone, or via video. Researchers examined over 7.5 million primary care encounters across the Veterans Health Administration from March 2020 to September 2021, one of the largest analyses of its kind. The study found that telehealth adoption wasn’t just influenced by demographics or digital access—it was most strongly associated with clinical conditions.
In-person visits were predominant (60.7%) and remained essential for managing chronic diseases requiring physical exams, lab work, or detailed assessments, such as diabetes, COPD, and asthma. Conversely, video visits were used more frequently for conditions where physical mobility is limited or where patients face barriers to clinic attendance, such as dementia, HIV, Parkinson’s disease, and behavioral health diagnoses like PTSD. Telephone visits, while widely used early in the pandemic, were more common for acute, low-complexity concerns or when patients lacked the capability for video.
Importantly, the study also observed geographic and racial disparities in modality of use. Patients in rural areas and Black patients were less likely to have video visits, raising concerns about digital health equity. However, after adjusting for diagnosis, much of the variation in telehealth modality was explained by clinical need rather than patient preferences or demographics.
Variability in Primary Care Telehealth Delivery Methods Across Chronic Conditions (Jacqueline M. Ferguson, PhD; Liberty Greene, MS; James Van Campen, MS, JAMA, 3/26).
