Why telehealth is not a one-size-fits-all solution

Written by Todd Bellemare, SVP Professional Services 

This is part two of our multi-part blog series on how COVID-19 impacted nearly every part of the healthcare industry.  

Our first stop on this journey began with telehealth’s incredible growth in 2020. In this post, we’ll take a closer look at the nuances of telehealth adoption to see how usage trends vary by specialty. 

What’s causing telehealth’s decline? 

In the early months of 2020, telehealth usage skyrocketed. While the volume still remains well above pre-pandemic levels to this day, we have seen a gradual decline as the pandemic continues into its second year. 

Fig. 1: Telehealth encounters by month from January 2020 to August 2022.  

What’s causing this decline?  Thanks to vaccines and the easing of lockdown restrictions, patients likely felt more comfortable returning to doctor’s offices in 2021. However, that doesn’t appear to paint the full picture.  

When we dig into the data, the explanation appears more nuanced. Some specialties, such as mental health, have found telehealth to be extremely useful. Other specialties, not so much.  

It may be that telehealth is not a universal success story. Let’s look at some of the specialties that may not be entirely suitable for telehealth.  

What specialties are not suitable for telehealth? 

Endocrinology is first the healthcare specialty we’ll look at.  

At a first glance at the chart below, we see a sharp increase in patient visit volume at the start of the pandemic. Endocrinology specialties had more than 40% of patient visits conducted over telehealth in April 2020.  

Fig. 2: The percentage of patients being treated for endocrine conditions via telehealth vs. in-person, from January 2020 to August 2022.  

However, we see a significant decline in telehealth patient visits starting in mid-2020 and continuing into 2021. As of summer 2021, telehealth volume plateaued around 10% of patient visits. 

From this information, we can infer that telehealth may not always be an effective care option for the treatment of endocrine conditions. If a diabetes patient experiences kidney failure, they may need dialysis for treatment, which typically requires the use of a machine and monitoring by a healthcare professional.  

Obviously, this is beyond the capabilities of telehealth, but that doesn’t mean that there is no role for telehealth to play in a patient’s journey. Instead, telehealth may be better suited to support, manage and maintain a healthcare provider’s existing care plan by being used after an initial face-to-face meeting. We’ll discuss it in more detail later.  

Dermatology is ill-suited for telehealth  

Next, we’ll look at dermatology. COVID-19 dramatically impacted dermatology patient volumes – more so than most specialties. 

 

Fig. 3: Percentage of patients being treated for dermatology conditions via telehealth vs. in-person, from January 2020 to August 2022. 

While telehealth usage accounted for 30% of total patient visits in April 2020, the overall volume of visits dropped by nearly half. Even though patient volume rebounded by June 2020, very few patients continued to use telehealth services to treat skin conditions. By July 2021, telehealth only accounts for 2% of total patient visits.  

Telehealth proved to be unsuited for effectively treating dermatologic conditions. Physicians often need to be in close proximity to their patients for an accurate, thorough examination and diagnosis and telehealth technology makes that challenging. In-depth skin checks that use dermatoscopes to examine and diagnose skin lesions and diseases cannot be conducted as comprehensively over a call or video chat.  

What does this mean for the future of telehealth?  

Healthcare providers searching for a telehealth solution from a healthcare IT vendor should consider that it won’t be a catch-all solution. Some important things to keep in mind about telehealth include:  

1. Specialties like audiology, dermatology, and ophthalmology often require the physician to be near the patient or use tools or medical devices to examine and treat patients.  

2. Accessibility is a concern. Patients typically need a smartphone or laptop with a camera and high-speed Internet to use a telehealth service.  

3. Similarly, patients in rural areas may not be able to access telehealth services if their region lacks the proper infrastructure.  

4. Telehealth’s rapid growth has made it a target of hackers and cyber security attacks, leaving provider and patient data at risk.  

5. New technology brings new legal and compliance issues. Providers will have to consider telehealth-specific regulations surrounding licensing, prescribing drugs and insurance coverage, especially as telehealth waivers put in place at the start of the pandemic expire.  

While no one can predict the future, telehealth likely won’t be the definitive solution to treat all (or some) healthcare conditions. Instead, telehealth services will be another tool in a physician’s toolbox.  

Learn more 

Missed an entry in our multi-part series on technology and specialties impacted by COVID? Catch up on telehealth’s explosive rise in our first post, or jump to the final entry. 

Each post in this series draws upon healthcare commercial intelligence from our platform to illustrate how the COVID-19 pandemic has reshaped the healthcare market. You can learn more by starting a free trial.