Telehealth largely drives fewer in-person follow-up visits, study shows

By Frank Diamond

Telehealth came into its own during the COVID-19 pandemic and even though there’s a push to have it play a bigger role in healthcare going forward just how big a role that should be remains to be seen.

white paper from Epic Research looks at how often a telehealth visit leads to a second telehealth or in-person visit and finds that the answer depends in large part on the specialty. Epic reviewed data from over 40 million specialty and 32 million primary care visits from January 2022 to March 2023.

Researchers found that for most specialties patients were more likely to have an in-person follow-up visit 90 days after an in-person visit rather than a telehealth visit. In addition, mental health saw the greatest difference in follow-up visits between initial in-person and telehealth visits: 10% for telehealth visits and 40% of in-person visits having a follow-up visit within 90 days.

“This study helps to show payers that telehealth can provide care that can stand alone, and this should be considered when determining whether to pay for telehealth visits in the future,” Jackie Gerhart, M.D., Epic Research’s CMO, told Fierce Healthcare in an email.

In primary care, a gap of only two percentage points separated follow-up visits between in-person and telehealth visits. Pediatrics and internal medicine were slightly more likely to have a follow-up visit after an initial telehealth visit.


“Family medicine saw nearly equivalent follow-up rates between telehealth and office visits that have in-person follow-up within 90 days,” the Epic white paper said.

The findings come as lawmakers debate whether expanded telehealth use rolled out during the pandemic should continue. For now, these flexibilities are scheduled to expire in 2024.

“These findings suggest that telehealth can continue to play an important role in care delivery across specialties without requiring additional visits for many patients,” the study said. “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.”

Pain medicine, mental health, physical medicine and rehabilitation had at least a 20% higher follow-up rate after an office visit than a telehealth visit. On the other hand, podiatry telehealth visits had an in-person follow-up rate of 13% more 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,” the white paper said.

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