For value-based care, virtual options aren't always beneficial, study shows

For value-based care, virtual options aren't always beneficial, study shows Andrea Fox

A new telehealth study by the University of Texas McCombs School of Business found that virtual care did not significantly lower costs, or reduce the number of future visits to emergency rooms or specialists for circulatory, respiratory and infectious diseases.

WHY IT MATTERS

Indranil Bardhan, a professor of information, risk and operations management at UTexas, and his co-authors, Sezgin Ayabakan of Temple University and Zhiqiang 'Eric' Zheng of UTexas at Dallas, examined telehealth through the theory of process virtualization – replacing physical interactions with virtual ones.

Based on a study of patient visits across all hospital-based outpatient clinics in Maryland from 2012 to 2021, telehealth visits did reduce the overall number of future outpatient visits within 30 days of a telehealth encounter by 14% and saved $239 in total outpatient costs per patient, the new study found.

But for diseases of the heart or lung, for example, the virtual visits did not offer the same value.

"The effectiveness of telehealth is really a function of the type of disease that it is used to treat," said Bardhan in Wednesday's announcement about the study published in Information Systems Research.

By contrast, "patients with mental health, skin, metabolic and musculoskeletal diseases exhibit a significant reduction of 0.21 outpatient visits per quarter (an equivalent cost reduction of $179) when they are treated via telehealth, suggesting a substitution effect with respect to traditional clinic visits," the authors said in the report abstract.

Bardhan said in the statement that the researchers hope their recommendations for developing telehealth programs enable more efficient use of resources "by encouraging healthcare professionals to focus telehealth on treating specific disease types and conditions where it can do the most good."

THE LARGER TREND

Happy Kids, a six-clinic pediatric practice based in Phoenix, Arizona, saw a significant loss of business during the COVID-19 pandemic and said it boosted VBC performance with telemedicine.

"Before the pandemic, we averaged between 1,800 and 2,000 visits per week. After integrating telehealth technology, we are seeing closer to 2,600 patients a week, which includes about 600 virtual visits," Dr. Jose Francisco Carrazco, founder of Happy Kids, told Healthcare IT News in November.

For years, telehealth proponents insisted that telehealth solved access and revenue issues, and the pandemic proved it. But it didn't work well for  Windrose Health Network, a federally qualified health center based in Greenwood, Indiana, near Indianapolis.

"Sometimes during telehealth visits some very subtle things – and some not-so-subtle things – can be missed," Scott Rollett, CEO of Windrose Health Network, told Healthcare IT News in 2021.

"As a general rule, patients who come to FQHCs are sicker and more medically complex than the average American, so when those things are missed, they can lead to some very poor health outcomes."

ON THE RECORD

"People believed that telehealth would be the next big thing, the future of healthcare," said Bardhan. "But our research shows that its impact is not as straightforward as people might think. It’s more nuanced."

Andrea Fox is senior editor of Healthcare IT News.
Email: afox@himss.org
Healthcare IT News is a HIMSS Media publication.