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. 2023 Jan;29(1):42-49.
doi: 10.37765/ajmc.2023.89302.

Health systems and telemedicine adoption for diabetes and hypertension care

Hector P Rodriguez  1 , Elizabeth L Ciemins, Karl Rubio, Cori Rattelman, John K Cuddeback, Jeff T Mohl, Salma Bibi, Stephen M Shortell
Affiliations

Health systems and telemedicine adoption for diabetes and hypertension care

Hector P Rodriguez et al. Am J Manag Care. 2023 Jan.

Abstract

Objectives: The COVID-19 pandemic accelerated telemedicine use nationally, but differences across health systems are understudied. We examine telemedicine use for adults with diabetes and/or hypertension across 10 health systems and analyze practice and patient characteristics associated with greater use.

Study design: Encounter-level data from the AMGA Optum Data Warehouse for March 13, 2020, to December 31, 2020, were analyzed, which included 3,016,761 clinical encounters from 764,521 adults with diabetes and/or hypertension attributed to 1 of 1207 practice sites with at least 50 system-attributed patients.

Methods: Linear spline regression estimated whether practice size and ownership were associated with telemedicine during the adoption (weeks 0-4), de-adoption (weeks 5-12), and maintenance (weeks 13-42) periods, controlling for patient socioeconomic and clinical characteristics.

Results: Telemedicine use peaked at 11% to 42% of weekly encounters after 4 weeks. In adjusted analyses, small practices had lower telemedicine use for adults with diabetes during the maintenance period compared with larger practices. Practice ownership was not associated with telemedicine use. Practices with higher proportions of Black patients continued to expand telemedicine use during the de-adoption and maintenance periods.

Conclusions: Practice ownership was not associated with telemedicine use during first months of the pandemic. Small practices de-adopted telemedicine to a greater degree than medium and large practices. Technical support for small practices, irrespective of their ownership, could enable telemedicine use for adults with diabetes and/or hypertension.

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Figures

Figure 1.
Figure 1.
COVID-19 Era Weekly Composition of Telemedicine Visits among Adults with Diabetes and/or Hypertension Across 10 Health Care Systems Analyses of weekly practice-level telemedicine visits as a proportion of overall visits among adults with diabetes and/or hypertension. Overall visits include in-person visits and telemedicine visits (video, audio, and e-visits).
Figure 2.
Figure 2.
Weekly Telemedicine Use Trends for Adults with Diabetes and/or Hypertension, by Health System, March 15-December 31, 2020 Analyses of weekly health care system-level telemedicine visits as a proportion of overall visits among adults with diabetes and/or hypertension. Overall visits include in-person visits and telemedicine visits (video, audio, and e-visits). The ten trend lines depict the weekly telemedicine use pattern for each of the ten health care systems.
See this image and copyright information in PMC

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