How to Increase Telemedicine Utilization

While the pandemic drove a surge in telehealth utilization — Epic Health Research Network reported that telehealth visits represented 69% of all medical visits in April 2020— it has since leveled off to ~21% of total visits. 

It should be noted that this is still significantly higher than the utilization rates seen prior to the coronavirus pandemic, which were in the range of 0.01%. Given that just one in three U.S. adults reported having used a telemedicine service during the first six months of the pandemic, however, there is still a lot of room for growth (source: Robert Wood Johnson Foundation). 

With this white paper, we will address the obstacles that still hinder telehealth adoption rates and provide recommendations on how to increase telemedicine utilization.

The Barriers to Higher Telehealth Utilization

1. Lack of Awareness and Clarity

If you are a healthcare provider, offer telehealth services or are responsible for administering employee benefits, you may find it confounding that a fairly sizable portion of the populace still isn't familiar with telemedicine, even though they may have access to it directly through their employer, insurers, or federal government programs like Medicare or Medicaid services. 

For those who do have a passing familiarity with the concept of telemedicine, there is still some confusion as to when and how to use it. 

Is it only for urgent care? Could it be used for primary care? Pediatric care? Outpatient procedures? Chronic conditions?   

It’s just not clear to many exactly where virtual care fits in their healthcare journey.

2. Lack of Access

Those people who are aware of telemedicine options may still experience disparities in access that can suppress utilization rates.

For those who live or work in rural areas, there may not be consistently reliable access to broadband. A survey from the Pew Research Center indicated that:

• 37% of those in rural areas do not have broadband access.
• 27% of Americans do not have access to broadband.

Those with lower socioeconomic status who often use Medicaid services may also experience access issues. In a recent study, RAND Corporation Senior Policy Researcher, Lori Uscher-Pines noted that “Lower-income patients may face unique barriers to accessing video visits, while federally qualified health centers may lack resources to develop the necessary infrastructure to conduct video telehealth.” 

For those who work in industries such as retail, transportation, education, manufacturing or oil and gas, there may not be ample opportunities to participate in a traditional telemed appointment over videoconferencing. The same goes for frontline workers with jobs as law enforcement officers, paramedics, EMTs and firefighters.

Worker availability in these kinds of fields can be fluid and difficult to predict. For instance, consider the ebb and flow of the traffic that a cashier at a big box retailer experiences in the course of a work day. 

3. Cognitive Overload

With many traditional telehealth services, patients are left to mentally work through a series of questions before they initiate a virtual visit.

• Will this cost me money, and if so, how much? 
• Will this be covered by my insurance? How will reimbursement be handled?
• Does how I currently feel warrant me paying money or should I just do nothing and hope that I feel better soon?
• If there is a backlog of telemedicine appointments and I won’t be able to connect with a clinician for a few hours or days, is that something that can wait or do I need more immediate patient care?
• What if I just want to ask a few quick questions to be more informed — for instance, about COVID-19 or the vaccine? Would I be charged for something that simple?

These questions can create internal conflict and lead patients to do nothing. The “cognitive load” just becomes too great and they default to inaction.

4. Concerns About Quality of Care

When weighing the use of telemedicine, patients are often skeptical regarding the quality of care that they will receive. In fact, when participants in a 2020 SYKES survey were asked about their telehealth concerns:

• 40% cited quality of care or accuracy of the diagnosis.

• 26% mentioned HIPAA- related issues such as security and privacy.

The most significant issue reported by 41% of respondents was that they weren’t convinced the telehealth services would properly diagnose and treat them. 

While patients report feeling confidence in physicians, there is lower confidence in the care and diagnoses provided by chatbot-driven encounters.

AI-driven patient intake processes may hold promise for some day improving provider efficiency in treating patients, but they impose a barrier for patients seeking immediate care. They are no substitute for the empathy, skill and judgement of a board-certified physician. 

How to Increase Telemedicine Utilization

1. Make Virtual Care Easy

The best way to ensure your telemedicine solution gets used is to offer telehealth services that are familiar to use and easy to understand. Don’t require your employees or health plan members to learn a whole new way of doing something. Provide them with a solution that already fits the modality of communication they prefer; for many people they will prefer text messaging. 

Simplicity also extends to how virtual care campaigns are communicated to your employees or members. Getting them to read the details around open enrollment is difficult enough, so make your telemedicine messaging easy to consume. 

Consider broadening beyond tried-and-true email campaigns to also include SMS Marketing, in-app messaging and social media. Studies have found that:

• 80 to 90% of people read text messages they receive...

• emails get an open rate of about 30%.

2. Make Virtual Care Immediate

Many telemedicine services have been created to replicate the traditional bricks and mortar office visit as a virtual visit. But that still introduces many of the same hassles and barriers, including the need to schedule appointments around the doctor’s availability rather than the patient’s. And even when a telehealth visit has been scheduled, it often involves wasted time in a virtual waiting room.

You will want to make sure that your telehealth provider can scale to meet demand so that wait times are kept to a minimum. 

In an on-demand world, introducing time constraints and obstacles like these will significantly diminish usage.   

To increase telehealth utilization, the focus should be on providing end users with instant, always-on access that can be used anywhere, any time. No scheduling. No waiting. No restrictions on the days or times that the service is available.

3. Make Virtual Care Affordable

“Free” is the most powerful word in the English language. It motivates people to take action and change behavior. 

By removing the mental gymnastics and the need to financially justify a telemedicine session, you encourage more patients to initiate care. If it is possible within your organization, consider partially or fully subsidizing the cost of telemedicine. 

Doing so can liberate employees or plan members to make greater use of telehealth — including preventive care — and address potential health issues early on rather than waiting for healthcare issues to become more acute. 

This is particularly true for behavioral health, where societal stigmas and financial obstacles to healthcare services can lead employees to forgo mental health counseling when they need it most. 

Removing the paywall for telehealth can actually improve your ROI by increasing the percentage of patients diverted from using high-cost options like a hospital emergency room or an urgent care center.

With telehealth services like CirrusMD, over 83% of patient encounters are resolved directly on-platform without requiring a referral or any other follow up care.

4. Make Virtual Care Patient-centered

The problem with many traditional telemedicine solutions is that they were designed on an outdated model that prioritized the workflow of physicians and payers over the convenience of patients.

Increasing telehealth utilization will require employers, brokers and health plans to provide telemedicine solutions that prioritize patient satisfaction, user-centered design and ease of use.

That includes making it available to use across devices and modalities: desktop, web, app, phone, video and chat.

It also includes making sure the provider network comprising your telehealth service is staffed with physicians trained, specialized and proficient in remote patient care. 

Your employees or plan members won’t want to engage with moonlighting clinicians with only a passing interest in the nuances of virtual care. They want telemedicine visits with board-certified physicians who have logged thousands of hours of remote patient care.

5. Integrate Virtual Care with Other Benefits

An intensified need to reduce healthcare costs has led employers and insurers to introduce a host of new benefits, many of them delivered virtually. The unintended consequence of these new benefits is that they are often point solutions, disconnected from one another. 

Consider the example of an employee experiencing insomnia. 

Her initial instinct may be to contact a physician for a prescription to treat her sleeplessness. But she also suspects that her insomnia may be related to increased levels of stress and anxiety. So what should be her first move? What benefit should she use? That’s where things get murky. 

Should she access her telemedicine provider? A virtual mental health provider? Her company’s Employee Assistance Program (EAP)? Or should she try one of the wellness services available to employees of her company?  

Ideally she could start with one application and, even if that solution isn’t the most appropriate for her condition, seamlessly be connected to another eligible employee or member benefit. 

There are healthcare navigation solutions that can enable this function, but there are also some telehealth services that can offer a single starting point, with live, licensed physicians who provide diagnoses and refer the patient to other eligible employee benefits if appropriate. This leads to a smoother patient journey, better continuity of care and higher patient satisfaction.

---

Conclusion

Work from home. COVID-19. Social determinants of health. Increased levels of stress and anxiety. They are all converging to fundamentally change the workplace. 

If telehealth adoption of your current virtual care offering is too low, it may be because it wasn’t created to serve the realities of the modern workforce. 

The key to increasing telehealth utilization and improving health outcomes requires solutions designed around the patient experience, with a focus on providing high-quality, physician-directed care that is easy, fast and affordable to access.