More U.S. physicians are using virtual consults as the COVID-19 crisis prompts HCPs and regulators to rethink telemedicine
Use of virtual consults by U.S. physicians has surged since implementation of social distancing measures, new data from Decision Resources Group’s Taking the Pulse® show.
Twenty-one percent of physicians surveyed from early March through mid-April said they had conducted a virtual consult in the past 12 months – up from 9% in 2019 – capturing a big shift towards telemedicine use that has taken place over the past six weeks.
Specialists treating at-risk patients are among the biggest adopters
That shift has been particularly pronounced within some specialties, notably those treating immunosuppressed patients. Forty-six percent of rheumatologists say they have participated in a virtual consult – up from 25% a year ago – as do 48% of medical oncologists, up from just 7% in 2019.
Telemedicine adoption by specialty
| Used in the past 12 months | % gain YOY | |
|---|---|---|
| Neurologists | 58% | +43 points |
| Medical oncologists | 48% | +41 points |
| Rheumatologists | 46% | +40 points |
| Pain management specialists | 46% | |
| Psychiatrists | 46% | +26 points |
| Hematology Oncologists | 32% | +20 points |
Source: Taking the Pulse® U.S. 2020
Regulatory roadblocks have fallen
Since March, the Trump Administration has taken a number of steps to lift regulatory restrictions and ease reimbursement policies around telemedicine, with the aim of blunting the spread of the novel coronavirus. It makes good sense for triaging care while limiting exposure, and is reviving a technology that had, prior to the pandemic, so far failed to take off.
Five years back, when telemedicine was a promising new technology, physician interest stood at 47% in the U.S., and 13% of physicians reported having already conducted a virtual consult.
Virtual consultation use and interest over time:
Source: Taking the Pulse® U.S. 2016-2020
Since then, however, there has been significant erosion in physician interest as the promise of telemedicine collided with a raft of state restrictions limiting reimbursement, along with a lack of a clear standout platform for tele-consults.
Physicians prefer platforms integrated into their practices
Part of the holdup in adoption probably reflects America’s fragmented healthcare system, which has given rise to a multitude of different platforms for tele-consults, including national companies offering virtual consults directly to consumers or in partnership with providers, along with systems run directly by pharmacies, hospitals, health systems and insurers. Physicians express a strong preference for services operated by or in partnership with their practices, over DTC offerings and those from external orgs, including pharmacies.
Physician use and interest in different types of telemedicine platforms
*Among U.S. physicians using, or interested in using, virtual consultations
Source: Taking the Pulse® U.S. 2019
With so many disparate providers of telehealth services and, until very recently, only modest use, it’s perhaps no surprise that many were reportedly buckling under the surge in demand resulting from the pandemic by mid-March.
A generation gap ripe for inversion
To date, telemedicine has been the near-exclusive province of the young, used by 1 in 3 Americans under the age of 35 in 2019 – but only 1% of those 65 and older. Given the particularly acute danger the COVID-19 virus poses for older people, with one Chinese study recording a nearly 15% mortality rate in patients over 80, that could change fast, as more at-risk older patients turn to telemedicine both for flu symptoms and to limit possible exposure when presenting with other conditions.
Patient-reported use of telemedicine by age
| All ages | <35 | 35-44 | 45-54 | 55-64 | 65+ |
|---|---|---|---|---|---|
| 18% | 34% | 24% | 8% | 5% | 1% |
Source: Cybercitizen Health® U.S. 2019
The urgency of the moment promises to “change the adoption curves of digital care,” as 23andMe’s Anne Wojcicki put it in a Tweet last month. Here’s hoping our nascent digital health infrastructure can scale up to meet the challenge and help flatten the curve.
