CDC: Telehealth visits more than doubled in March 2020
A report from the U.S. Centers for Disease Control and Prevention released Friday found a 154% increase in telehealth visits during the last week of March 2020, compared with the same time period in 2019.
Using de-identified patient data from Amwell, Teladoc Health, MDLive and Doctor On Demand, the CDC found that about 1.6 million telehealth encounters occurred from January through March 2020 – what the agency calls the "early pandemic period." This was 50% higher than the approximately 1 million encounters during the same period in 2019.
"Telehealth can serve an important role in pandemic planning and response," the authors wrote. "Continued availability and promotion of telehealth services might play a prominent role in increasing access to services during the public health emergency."
WHY IT MATTERS
It has been difficult, as the CDC notes, to quantify interest in telehealth, in part because of the large number of telehealth providers and the rapid scale-up of virtual care programs with the emergence of the COVID-19 pandemic.
However, the CDC report offers some insight with regard to the four major vendors' clientele.
Perhaps unsurprisingly, the proportion of visits related to COVID-19 symptoms increased during the last three weeks of March 2020, from 5.5% to 16.2%. COVID-19-like illness was defined as fever plus cough or sore throat or shortness of breath. Patient encounters that did not include one of the described criteria were described as not COVID-19-related.
"The findings in this report are subject to at least two limitations," the authors noted. "First, the data in this analysis are from a sample of four large national telehealth providers and do not represent all virtual encounters conducted during the study period.
"In addition, the symptoms used initially to identify patients with possible COVID-19 were limited, and it was not possible to distinguish them from those with influenza-like illness symptoms or other respiratory conditions; therefore, some patients might have been unidentified or misclassified."
Most of the telehealth encounters were with adults aged 18-49 years, and 63% of the patients were female. The percentage of virtual care encounters with children actually decreased from 2019 to 2020.
Nearly 70% of the patients who had a telehealth encounter during the early pandemic period managed their care at home, with about a quarter advised to seek follow-up care. About 1.5% were advised to seek emergency department care, and 3% were referred to an urgent care setting.
"Overall, an estimated 41% to 42% of U.S. adults reported having delayed or avoided seeking care during the pandemic because of concerns about COVID-19, including 12% who reported having avoided seeking urgent or emergency care. The sharp rise in telehealth encounters might be temporally associated with these declines in in-person visits," wrote the report authors.
THE LARGER TREND
The report notes that the rise in telehealth numbers might be attributed to relaxations of federal regulations around virtual care, including out-of-state licensures, reimbursement guidance and originating site specifications.
It follows on the heels of new numbers from the Centers for Medicare and Medicaid Services, which reported that 34.5 million telehealth services were delivered from March through June.
That preliminary data suggests a whopping 2,532% increase in services delivered compared with March through June 2019.
ON THE RECORD
"Telehealth might have multiple benefits for public and individual health during the COVID-19 pandemic," wrote the CDC report authors. "During the latter weeks in March 2020, remote screening and management of persons who needed clinical care for COVID-19 and other conditions might have increased access to care when many outpatient offices were closed or had limited operating hours. The increased availability of telehealth services also might have reduced disease exposure for staff members and patients, preserved scarce supplies of personal protective equipment, and minimized patient surge on facilities.
"In addition, most patients seeking telehealth in the early pandemic period were managed at home, which might have reduced large volumes of patients seeking care at health care facilities," they said. "Access to telehealth services might have been particularly valuable for those patients who were reluctant to seek in-person care, had difficulty accessing in-person care or who had chronic conditions that place them at high risk for severe COVID-19."