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The Impact of Telehealth on Primary Care Physician Panel Sizes: A Modeling Study
Linda V Green1, Sergei Savin2, Grant Greenberg2
1From Columbia Business School, Columbia University, New York, NY (LVG); Wharton School, University of Pennsylvania, Philadelphia, PA (SS); Lehigh Valley Health Network, Whitehall, PA (GG, MM and RXM); and Crystal Run Healthcare, Middletown, NY (SH and DL). lvg1@columbia.edu.
Introduction:
Most research on the use of telehealth in lieu of in-office visits has focused on its growth, its impact on access, and the experience of physicians and patients. One important issue that has not gotten much attention is the potential for telehealth to significantly increase physician capacity by reducing nonvalue adding activities and patient no-shows. We explore this in this article.
Methods:
We use data from the electronic health records of 2 health care systems and information gathered from family medicine physician focus groups to develop estimates of visit durations and no-show rates for tele-visits. We use these in a simulation model to determine how patient panel sizes could be increased while maintaining high levels of access by substituting tele-visits for in-person visits.
Results:
We found that tele-visits reduce the nonvalue-added time physicians spend with patients as well as patient no-shows. At current levels of tele-visit utilization, the use of tele-visits may translate into more than a 10% increase in patient panel sizes assuming a modest reduction in visit durations and no-shows, and as much as a 30% increase assuming that half of all visits could be effectively conducted virtually and result in a greater reduction in visit durations and no-shows.
Discussion:
Our study provides evidence that a major benefit of using telehealth for many routine encounters is a reduction in wasted physician time and a substantial increase in the number of patients that a primary care physician can care for without jeopardizing access to care.
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