Telehealth for surgical specialties saw a slow decline after June 2020

A new study published in the Journal of the American Medical Association Network Open found that while telehealth grew across surgical specialties in response to the COVID-10 pandemic, rates have declined as in-person care resumed.

The study found that among 4,405 Michigan-based surgeons, telehealth use peaked in April 2020, with a slow decline after June through September.

“Within surgical fields, telehealth had been previously used for preoperative and postoperative follow-up visits, although at low levels prior to the COVID-19 pandemic,” the study authors wrote.

“While telehealth use in surgery has shown to be feasible, the profession found itself in a novel situation during the COVID-19 pandemic, wherein telehealth became a major modality of health care delivery,” they continued.

Why It Matters
The pandemic-fueled boost in telehealth use across the medical industry has been well documented. Researchers are still investigating how different specialties have relied on virtual care.

For the JAMA Network Open study, the team examined insurance claims from a Michigan statewide commercial payer for new patient visits with a surgeon from one of nine surgical specialties: colorectal surgery; general surgery; neurosurgery; obstetrics and gynecology; ophthalmology/ear, nose, and throat; orthopedics; plastic surgery; thoracic surgery; and urology.

Researchers found that telehealth was used by 58.8% of the 4,405 active surgeons in the cohort.

From March 8, 2020 through September 5, 2020, the team identified 109,610 surgical new outpatient visits – compared with eight total during the same time in 2019. It’s fairly clear, then, that the astronomic rise in telehealth rates extended to surgical specialties.

Still, conversion rates – defined as the rate of weekly new patient telehealth visits divided by the mean weekly number of total new patient visits in 2019 – remained fairly low across the board, with most below 10%.

Those with the highest rates of telehealth conversion were neurosurgery and urology. The specialty with the lowest rate between March 8 and June 6 was orthopedics, while ENT had the lowest rate between June 7 and September 5.

The study notes that telehealth use declined starting in June 2020, for a number of probable factors: clinics reopening for in-person care, patients who had deferred care returning, and the perception of telehealth as a temporary solution.

“Additionally, in a field where physical examination is used to diagnose and to determine treatment plans, many surgeons have not been trained in how to assess patients via telehealth. Thus, many may consider it unsafe or inefficient to provide care via telehealth,” wrote researchers.

Researchers also flagged enduring barriers to telehealth use, including: a lack of private space, poor telephone or Internet connection, no device on which to contact clinicians, and difficulty understanding how to engage with virtual platforms.

“This study shows that telehealth conversion in surgery is not a one-size-fits-all solution,” wrote the team.

The Larger Trend
As more data emerges about telehealth use rates, questions remain about whether virtual care use will continue after the pandemic.

The verdict seems to be: probably, but to a lesser degree. And it will depend on the specialty. Maintaining access to behavioral healthcare via telemedicine has been consistently cited as a priority by lawmakers at both the state and federal level.

On The Record
“Telehealth was used by surgeons during the COVID-19 pandemic at much higher rates than in the past, with significant variation across specialties,” read the study.

“Determining the ideal rate of conversion to telehealth depends on the clinical needs of patients. Therefore, future research must focus on clinical outcomes for patients,” the researchers added. Healthcare IT News