Transitioning from In-Person to Telemedicine Within Primary Care Behavioral Health During COVID-19

Area of Science:

• Health Services Research
• Mental Health
• Telemedicine

Background:

• The COVID-19 pandemic introduced significant mental health stressors, potentially disrupting access to primary care behavioral health (PCBH) services.
• Rapid shifts to telehealth presented challenges and opportunities for PCBH service delivery.

Purpose of the Study:

• To assess the feasibility, acceptability, and clinical outcomes of PCBH services delivered via telehealth compared to in-person visits.
• To evaluate patient satisfaction with telehealth services in a PCBH setting.

Main Methods:

• A retrospective cohort comparison study analyzed administrative data and patient surveys.
• Two cohorts were compared: pre-pandemic in-person visits (Cohort 1) and post-pandemic telehealth-only visits (Cohort 2).
• Outcomes included patient reach, visit frequency, no-show/cancellation rates, changes in PHQ-9 and GAD-7 scores, and patient satisfaction.

Main Results:

• Both cohorts showed statistically significant improvements in depression (PHQ-9) and anxiety (GAD-7) scores.
• Telehealth patients (Cohort 2) were more likely to have anxiety diagnoses and higher initial/final anxiety severity, with fewer average visits and higher cancellation rates.
• Treatment cohort was not a significant predictor of final PHQ-9 or GAD-7 scores.

Conclusions:

• PCBH telehealth services are feasible and acceptable to patients, demonstrating comparable clinical improvements to pre-pandemic in-person care.
• Telehealth effectively facilitated access to behavioral health services, despite challenges like higher anxiety severity and cancellations in the telehealth cohort.
• Patient satisfaction with telehealth ease of use and effectiveness was high.