Telemedicine Use across Medical Specialties and Diagnoses

Area of Science:

• Health Services Research
• Digital Health
• Medical Informatics

Background:

• The COVID-19 pandemic accelerated telemedicine adoption, making it a routine care component.
• Understanding factors influencing telemedicine use is crucial for addressing its limitations.

Purpose of the Study:

• To analyze how medical specialty, diagnosis, and patient demographics interact to shape telemedicine usage patterns.
• To identify disparities in telemedicine modality selection across different patient groups and specialties.

Main Methods:

• Extracted outpatient encounter and patient data from an academic health system (June 2020-June 2021).
• Analyzed relationships between specialty, diagnosis, visit modality (video, audio, in-person), and patient characteristics (age, sex, race/ethnicity, rural-urban status).
• Utilized mixed-effects logistic regression to assess associations between patient characteristics and telemedicine modality.

Main Results:

• Nearly 2.5 million encounters were analyzed, with diagnoses requiring physical exams favoring in-person visits.
• Rural patients showed varied video telemedicine use by specialty; males and non-white patients generally used video less.
• Demographic groups exhibited unique telemedicine usage patterns, particularly in Psychiatry, influencing overall adoption.

Conclusions:

• In-person visits are preferred for diagnoses needing physical examination or minor procedures.
• Patient demographics significantly influence telemedicine modality choice, varying by medical specialty.
• These disparities highlight the need to address perceived usefulness and accessibility to ensure equitable telemedicine adoption.