We previously published two studies that showed that most telehealth appointments didn’t require an in-person follow-up appointment in the next 90 days.1,2 For this study, we compared how follow-up rates differ for in-person visits versus telehealth visits.
We studied 40,689,760 specialty and 32,146,821 primary care encounters from January 2022 to March 2023 to determine in-person follow-up rates after a telehealth visit versus an office visit. We excluded specialties with fewer than 300,000 encounters during the study period. Of the 24 specialties we evaluated, we found that 16 specialties had in-person follow-up after an office visit more often than after a telehealth visit.
Mental health, physical medicine and rehabilitation, and pain medicine had at least a 20% higher follow-up rate after an office visit than a telehealth visit. Conversely, podiatry telehealth visits had an in-person follow-up rate 13% more than office visits. Of note, telehealth use in 2022 and early 2023 was infrequent for most specialties, with only sleep medicine and mental health specialties conducting at least 20% of encounters using telehealth.
Follow-up rates for telehealth and office visits in primary care were within two percentage points of each other with pediatrics and internal medicine slightly more likely to have follow-up after telehealth. Family medicine saw nearly equivalent follow-up rates between telehealth and office visits that have in-person follow-up within 90 days.
Expanding the analysis to include any type of follow-up (telehealth or in-person) showed greater rates of follow-up after office visits for most specialties. However, all types of primary care have a slightly higher follow-up rate after telehealth when including both telehealth and in-person visits in the next 90 days.
These findings suggest that telehealth can continue to play an important role in care delivery across specialties without requiring additional visits for many patients. Of note, there may be differences in the patient populations that seek care through telehealth and in-person visits, such as age, acuity of their condition, and other potential confounders that may influence the likelihood of follow-up care required.
Original Publication Date: June 29, 2022
Last Updated: July 7, 2023
These data come from Cosmos, a HIPAA-defined Limited Data Set of more than 190 million patients from 208 Epic organizations including 1,197 hospitals and more than 25,400 clinics, serving patients in all 50 states and Lebanon. This study was completed by two teams that worked independently, each composed of a clinician and research scientists. The two teams came to similar conclusions.
References
- Gerhart J, Piff A, Bartelt K, Barkley E. Telehealth Visits Unlikely to Require In-Person Follow-Up Within 90 Days. Epic Research. Dec 13, 2022. Telehealth Visits Unlikely to Require In-Person Follow-Up Within 90 Days (epicresearch.org) Accessed June 19, 2023.
- Gerhart J, Piff A, Bartelt K, Barkley E. Most Primary Care Telehealth Visits Unlikely to Need In-Person Follow-Up. Epic Research. Feb 24, 2023. Most Primary Care Telehealth Visits Unlikely to Need In-Person Follow-Up (epicresearch.org) Accessed June 19, 2023.