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. 2020 Oct 1;3(10):e2022302.
doi: 10.1001/jamanetworkopen.2020.22302.

Prevalence and Characteristics of Telehealth Utilization in the United States

Shira H Fischer  1 , Kristin N Ray  2 , Ateev Mehrotra  1   3 , Erika Litvin Bloom  1 , Lori Uscher-Pines  4
Affiliations

Prevalence and Characteristics of Telehealth Utilization in the United States

Shira H Fischer et al. JAMA Netw Open. .

Abstract

Importance: Telehealth services, which allow patients to communicate with a remotely located clinician, are increasingly available; however, prevalence of telehealth use, including videoconferencing visits, remains unclear.

Objective: To measure the use of and willingness to use telehealth modalities across the US population.

Design, setting, and participants: This survey study, conducted between February 2019 and April 2019, asked participants about their use of different telehealth modalities, reasons for not using videoconferencing visits, and willingness to use videoconferencing visits. Questions were continuously posed to panel members and closed after 2555 responses were obtained, at which point 3932 panel members had been invited, for a 65.0% response rate.

Exposures: Demographic characteristics (ie, age, sex, race, rural/urban residency, education level, and income).

Main outcomes and measures: Self-reported use of specific telehealth modalities, reasons for nonuse, and willingness to use videoconferencing in the future.

Results: A total of 2555 individuals completed the survey with a mean (SD) age of 57.2 (14.2) years; 1453 respondents (weighted percentage, 51.9%) were women, and 2043 (weighted percentage, 73.4%) were White individuals. Overall, 1343 respondents (weighted percentage, 50.8%) reported use of a nontelephone telehealth modality, ranging from 873 respondents (weighted percentage, 31.9%) for patient portals and 89 respondents (weighted percentage, 4.2%) for videoconferencing visits. Although 1309 respondents (weighted percentage, 49.2%) overall answered that they were willing or very willing to use videoconferencing visits, respondents who were Black individuals (OR, 0.58; 95% CI, 0.38-0.91), aged older than 65 years (OR, 0.51; 95% CI, 0.40-0.66), or had less education (high school or less vs advanced degrees: OR, 0.37; 95% CI, 0.25-0.56) were less likely to express willingness.

Conclusions and relevance: Despite the focused policy attention on videoconferencing visits, the results of this survey study suggest that other forms of telehealth were more dominant prior to 2020. Targeted efforts may be necessary for videoconferencing visits to reach patient groups who are older or have less education, and payer policies supporting other forms of telemedicine may be appropriate to enhance access.

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Conflict of interest statement

Conflict of Interest Disclosures: Dr Bloom reported receiving personal fees from WayBetter, Inc., outside the submitted work. No other disclosures were reported.

Figures

Figure 1.
Figure 1.. Proportion of Respondents Who Reported Ever Using Various Telehealth Modalities, Weighted
Multiple choices could be selected; telephone visits were not included in this analysis. In this survey, an eVisit was described as “when you answer questions about your health issue online and hear back from a doctor later.”
Figure 2.
Figure 2.. Univariate Comparisons of Willingness to Use Videoconferencing by Demographic Characteristic
Comparison for sex P < .05; all other comparisons P < .001.
Figure 3.
Figure 3.. Reasons for Not Using Videoconferencing by Demographic Group
Respondents could answer with more than 1 reason.
See this image and copyright information in PMC

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