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September 29, 2022

13 ways telehealth actually beats in-person care on quality

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    In a new study published in JAMA Network Open, telemedicine scored higher on 13 of 16 Healthcare Effectiveness Data and Information Set (HEDIS) measures, suggesting that telemedicine delivers similar or better quality care than in-person visits.

    Study details and key findings

    For the study, researchers analyzed data from 526,874 patients across 200 outpatient care sites in Pennsylvania and Maryland who had either telehealth visits or in-person visits between March 1, 2020, and Nov. 30, 2021.

    Of the patients included in the study, 409,732 only had in-person visits, and 117,142 were exposed to telemedicine.

    Researchers analyzed the care quality performance of both patient groups for 16 HEDIS measures, which were selected across five domains of primary care, including cardiovascular, diabetes, prevention and wellness, behavioral health, and pulmonary. 

    In 13 of the 16 medication, testing, and counseling-based measures, patients who were exposed to telemedicine reported similar or significantly better quality performance than those who were only exposed to in-person visits.

    Notably, telemedicine was more likely to meet HEDIS quality measures than in-person care alone in all counseling and testing-based measures, which includes vaccinations, cardiovascular disease and diabetes testing, and depression and cancer screenings.

    For medication-based HEDIS measurespatients who only had in-person visits typically reported better quality performance. However, there were only significant differences between telemedicine and in-person patients in three of the five measures.


    According to Derek Baughman,an author of the study and medical director at Barksdale Air Force Base and Medical Clinic, the higher quality scores telemedicine received suggest that remote care—like in-office care—is worth the cost of reimbursement.

    "This isn't just one or two measures, it's showing that for most of the measures, we're providing at least comparable quality," Baughman said. "We're not making these measures worse."

    The study's findings are examples of clinical domains where patients could rely on telemedicine instead of in-office care, Baughman added. Ultimately, using telemedicine to manage diseases and preventive care could result in better quality outcomes and more affordable care.

    "It's not that we're going to eliminate the need for an in-office encounter. We're just saying when we have a recession, inflation, and people with limited resources, if you can balance the scales in overall spending, you can still provide a comparable quality of that care in certain scenarios," Baughman said. 

    Krista Drobac, executive director of the Alliance for Connected Care noted that the data in this study should lead to additional research to determine why telemedicine received higher scores in some cases.

    "Maybe it's because if you can more easily check in with your practitioner without having to get childcare and go through traffic and parking and all of that, you might be more apt to manage your disease on an ongoing basis," Drobac said. 

    According to Drobac, any future studies should gauge patient perception of telehealth, and include more diverse patients, noting that that this study was largely composed of white patients who only experienced in-person visits.

    "We've always said that telemedicine is medicine," Drobac said. "It's just a different modality and so the quality should be comparable." (Devereaux, Modern Healthcare, 9/27; Baughman et al., JAMA Network Open, 9/26)

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