Telehealth - Megan Coffman
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Transcript of Telehealth - Megan Coffman
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Robert Graham Center:Summary of Telehealth
Projects
Megan Coffman, MS
October 28, 2016
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Robert Graham Center The Robert Graham Center aims to improve individual and population healthcare delivery
through the generation or synthesis of evidence that brings a family medicine and primary care perspective to health policy
deliberations from the local to international levels.
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Robert Graham Center – Who We Are
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Research Topics
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Mapping Tools
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What is Telehealth?• Telehealth: the exchange of medical
information from one location to another via electronic communications
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Why Telehealth? • Telehealth is shown to:
– expand patients access to care, – increase continuity of care, – improve coordination of care – reduce healthcare costs, and – improve health outcomes
• Some indication of low usage in primary care
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Family Physicians and Telehealth
Funded by Anthem,Inc.
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Highlights from the Literature Review and Expert Panel
• There is very little research on telehealth in primary care
• The literature indicates that patients appreciate the convenience of access to telehealth services, and are satisfied with the care they receive remotely
• Patients see saving time and travel as benefits of telehealth compared to in-person care
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Survey Objectives• Measure penetration of telehealth into primary care
setting– Hypothesis: low penetration
• Characterize Family Physicians (FPs) who use telehealth– Hypothesis: higher use in rural setting, larger practices,
and younger physicians• Investigate Attitudes/Beliefs of FPs regarding
telehealth– Hypothesis: Users have more favorable attitudes/beliefs
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Who did we ask? • Survey of 5,000 randomly selected FPs
– AMA Physician Masterfile (2014) linked to AAFP member list
– FPs in direct patient care– Oversample rural 2:1
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The Survey
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Telehealth DefinedTelehealth services defined as:
1. Primary care services: a physician providing care for a patient via live interactive video and/or
2. Primary care and specialist referral services: a primary care provider consulting with a specialist via live interactive video and/or
3. Store and Forward: sharing electronic patient data between a primary care provider and specialist across locations
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Survey Data• 1,557 survey responses were analyzed
– 1,630 surveys were returned (31% response rate)– 53 surveys were returned but not used
• Non-unique ID• Respondent indicated they did NOT engage in direct
patient care or did not answer this question
• Sample weights were used to ensure the estimates computed were representative of family physicians across the United States
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Results: Demographics• 15% had used telehealth services in the
last 12 months (85% had NOT) (N=225)• Telehealth users were more likely to
– rural setting (26% versus 12%, p<0.01)– use an EHR (97% vs. 92%, p<0.01)– work with six+ FPs (40% vs. 29%, p<0.01)
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Prevalence of Telehealth Use by Type of Service Used
Source: Robert Graham Center Analysis of 2014 AAFP Telehealth Survey of Family Physicians, N=225
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Results: Attitudes and Beliefs
• Telehealth users and non-users agree:– Telehealth improves access to care for my
patients. (89% users vs. 77% non-users, p<0.01)
– Telehealth improves the continuity of care for my patients. (75% vs. 68%, p<0.01)
– Patients prefer to see their doctor in person. (83% vs. 94%, p<0.01)
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Results: Barriers to Using Telehealth
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Benefits and Barriers to Telehealth Use
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FP Survey Study Conclusion
• FPs views of telehealth are generally positive
• Barriers to larger adoption remain• Small but significant number of family
physicians who are providing telehealth services for patients
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CERA Survey of Family Medicine Directors
19%
11%
71%
Telehealth Capacity of Residency Programs Surveyed
Video and Evisits or Store Forward VideoOnly Evisits or Store Forward Only
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Percent of Residency Programs Who Indicated Each Reason by Mode of Telehealth Service Delivery
Diagnosis & Treatment
Second Opinion Follow-up Chronic Disease Management
Emergency Care Administration0
10
20
30
40
50
60
48.6
11.4
22.928.6
2017.1
48.1
21.7
55.7
49.1
16
36.8
Live Interactive VideoEvisits / Store Forward
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Consumer Telehealth Project
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Consumer Expert Panel
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Consumer Survey
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Thank You and More • To learn more about the Robert Graham
Center’s work, visit our website: http://www.graham-center.org/rgc/home.html
• If you have specific questions on the telehealth project, email me at: