Imaging Utilization Differences After Telemedicine Versus In-Person Visits.

Area of Science:

• Health Services Research
• Radiology
• Digital Health

Background:

• The COVID-19 pandemic accelerated telemedicine adoption.
• Impact of telemedicine on diagnostic imaging utilization remains unclear.

Purpose of the Study:

• To evaluate differences in diagnostic imaging utilization following telemedicine versus in-person visits.
• Assess national-level trends in imaging after virtual and in-person consultations.

Main Methods:

• Retrospective case-control study using de-identified national insurance data (2021).
• Matched telemedicine and in-person visits.
• Weighted multivariate linear models to compare post-visit imaging rates and counts within 7, 14, and 30 days.

Main Results:

• Telemedicine visits had a 2.4 pp lower 7-day imaging utilization rate (29.7% relative decrease) compared to in-person visits.
• This lower utilization trend persisted at 14 and 30 days.
• A slight increase in the number of imaging studies (0.02, 1.5% relative difference) was observed for telemedicine visits with post-visit imaging.

Conclusions:

• Telemedicine is associated with reduced diagnostic imaging utilization compared to in-person visits.
• Telemedicine may not be a significant driver of increased imaging growth.
• Further research is needed to assess the appropriateness of imaging ordered during telemedicine encounters.