Telemedicine visits comparable to in-person visits for addressing most patient clinical concern areas in primary care

A study of more than 1 million adults has found that in primary care, telemedicine visits were comparable to in-person visits for addressing most patient clinical concern areas. Telemedicine visits resulted in lower treatment rates and higher rates of follow-up health care use compared with in-person office visits, but these differences were small and varied by clinical condition. The findings are published in Annals of Internal Medicine.

While telemedicine use expanded greatly during the COVID-19 pandemic, driven primarily by social distancing efforts, longer-term use of telemedicine can continue to offer patients a convenient option and expand access to primary care.

However, beyond initial pandemic-related telemedicine, there is limited evidence for whether longer-term use of telemedicine visits in clinical practice adequately addresses patients' needs, increases the likelihood of subsequent follow-up visits, or is more likely to be followed by a serious health event requiring an emergency department visit or hospital stay.

Researchers from Kaiser Permanente Division of Research conducted a retrospective study based on administrative and electronic health record data of 1,589,014 adult patients between April and December 2021 to compare treatment and follow-up visits (office, emergency department, hospitalization) between primary care video or telephone telemedicine and in-person office visits. The data showed that about half of all primary care visits within the study were telemedicine visits and medications were prescribed during 46.8% of in-person visits, 38.4% of video visits, and 34.6% of telephone visits.

Only 1.3% of in-person visits had a follow-up appointment within 7 days of the initial appointment, while 6.2% of video visits and 7.6% of telephone visits had a follow-up appointment. Differences in follow-up office visits varied by clinical area and were largest after in-person office versus telephone visits for acute pain conditions and smallest after office versus telephone visits for mental health.

Overall, the rates of follow-up emergency department visit and hospitalizations were low, and differences between in-person visits and telemedicine visits were small.