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Survey Cites Family Doctors’ Resistance to Telehealth

A 2014 survey lists infrastructure issues as the primary reason that only 15 percent of family practitioners are using telehealth.

By Eric Wicklund

- A 2014 survey of family physicians finds that while a vast majority see the benefits of telehealth, only 15 percent are actually using it.

The survey of almost 1,560 physicians, conducted by the Robert Graham Center for Policy Studies in Family Medicine and Primary Care and funded by Anthem, cited infrastructure issues as the primary barriers to telehealth adoption. Slightly more than half of those surveyed cited lack of reimbursement and lack of training as barriers, while 45 percent listed the cost of equipment and 41 percent cited potential liability issues.

The results fall in line with the plethora of surveys and studies that say healthcare providers would benefit from adopting telehealth – but they’re not compelled to use it.

While only 15 percent of those surveyed reported using telehealth during the preceding 12 months, 78 percent feel that telehealth could improve access to care, and 68 percent feel that it could improve continuity of care.

The survey’s results were contained in a 22-page report prepared last October and cited in the Jan. 15 issue of the American Academy of Family Physicians’ American Family Physician newsletter.

“Overall, the findings of this survey confirm that family physicians see promise in the ability of telehealth to improve access to primary care services,” the report concludes. “The findings also suggest that telehealth is on the cusp of advancing from a tool used occasionally to a tool implemented on a routine basis. However, use of telehealth services will not become widely adopted until health systems are reformed to address barriers.”

According to the survey’s authors - Kathleen Klink, MD; Megan Coffman, MS; Miranda Moore, PhD; Anuradha Jetty, MPH; Stephen Petterson, PhD; and Andrew Bazemore, MD, MPH  ­– the results point to a “small but significant number of family physicians” who are using telehealth. The typical family physician using telehealth, they said, lives in a rural area, is part of complex practice that may be part of a larger health system, and is more likely to work with other health providers who aren’t clinicians.

In addition, family practitioners using telehealth tend to be younger, have practiced for less than a decade and use an EHR. In terms of frequency, more than half of those using telehealth reported that they used the technology up to five times during the previous year, while almost a quarter said they used telehealth at least 20 times. More than half used telehealth for diagnosis or treatment, and 25 percent said they used it for chronic disease management.

Interestingly, among the barriers cited, the survey reports that while state restrictions on Medicaid reimbursement for telehealth have stymied physicians, the Centers for Medicare & Medicaid Services has been moving to increase Medicaid reimbursement opportunities for telehealth, yet Medicare claims for telehealth “has been modest,” with a majority of those filing being mental health professionals or non-physicians.

The report also cites “relatively few studies that focus specifically on the practice of telehealth and even fewer that focus on the use of telehealth services in a primary care setting.” It notes that consumer surveys offer strong support for telehealth, while physicians have been more reluctant, and may imply that physicians are more apt to dismiss telehealth for its perceived barriers, rather than having any proof that the technology would harm their business.

“Telehealth has the potential to alter the entire practice of medicine, just as the home computer and smartphones have altered information exchange and communication worldwide,” the survey’s authors conclude. “While telehealth services remain in the early stages of implementation, the findings from this survey are an important step toward identifying the key issues facing physicians as they enter this new realm of healthcare delivery.”


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