Unlocking Care: How Telehealth Empowers New Patients to Access More Comprehensive Services at a Tertiary Referral...

Health care delivery has undergone a shift from in-person visits to more remote consultations via telehealth. Despite the increasing adoption of telehealth for tertiary medical centers' new patient visits, its impact on subsequent in-person health care utilization has not been widely studied. Our objective was to examine differences in health care services used by patients who established care in-person versus those who initiated care remotely via telehealth.

We conducted a retrospective review of all patients who established care at one of our three main Mayo Clinic campuses through either an in-person or telemedicine visit between September 1, 2023, and September 30, 2024. We analyzed aggregate data related to downstream in-person services encompassing diagnostic studies, outpatient procedures, surgical procedures (referred to as "surgical yield"), specialist consultations, and follow-up appointments.

This study evaluated 252,356 new patient visits, of which 14,915 (5.9%) were performed remotely via telemedicine. Patients who established care in-person had an average of 10.47 subsequent in-person visits. Among patients who initiated care via telemedicine, 62.7% (9,351) later received in-person services, with an average of 16 in-person visits per patient. Surgical yield was higher for patients who started remotely via telehealth and then came on-site, at 29% compared to 16% for those who started with an on-site visit. States bordering the clinic locations had increased percentages of in-person visits compared to states that required patients to travel longer distances.

Patients who established care through an initial telemedicine appointment and then came on-site had more downstream encounters and surgical procedures than those who began in-person. This may be due to the ability to efficiently coordinate multiple appointments within a condensed timeframe, optimizing the planning of on-site visits. Additionally, both patients and providers may selectively utilize telemedicine to identify individuals who would derive the greatest benefit from in-person care.