Virtual visits don't lead to more follow-ups, Kaiser study finds

Patients who saw their physicians via telehealth didn't need more follow-ups than patients who had in-person appointments, according to an Oakland, Calif.-based Kaiser Permanente study published Nov. 16 in JAMA Network Open.

For its study, researchers examined 2.2 million video, phone and in-person visits scheduled online by Kaiser members in North California from 2016 to mid-2018. About 14 percent of the appointments were virtual. 

Six things to know: 

  1. The study found that video, phone, and in-person visits had similar rates of follow-up appointments, emergency room visits, or hospitalizations.

  2. Researchers found that 25.4 percent of video visits had a follow-up; 26 percent of phone visits had one; and 24.5 percent of in-person visits a follow-up.

  3. Mary Reed, DrPH, research scientist and lead author with the Kaiser Permanente research division, said the study suggests that virtual visits are comparable with in-person medical care.

  4. "This study answers the previously open question about whether video and phone visits are less efficient because the bulk of patients might have to come to the clinic anyway to resolve their clinical issue," Dr. Reed said. "We found there is a small margin of additional patients who return for an in-person visit after telemedicine, but it is surprisingly small: less than 2 percent."

  5. Medication was prescribed more frequently at in-person visits. Medication was prescribed at 60 percent of clinic visits; 38.6 percent of video visits; and 34.7 of phone visits. Lab tests or imaging were also ordered more frequently at office visits (59.3 percent of the time), compared to 29.2 percent of video visits and 27 percent of phone visits.

  6. "It is possible that these differences in treatment might be driven by the types or seriousness of concerns that patients chose for each visit type, or by the degree to which physicians could assess the patient in each visit type," Dr.  Reed said.

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