Diagnoses from preliminary telehealth consultations matched in-person visits in 86.9% of cases, according to a study published in JAMA Network Open.
The research included 2,393 Mayo Clinic patients who attended a video telemedicine visit, followed by an in-person appointment for the same problem in the same specialty within 90 days. Patients used desktop computers, laptops, tablets or smartphones in their homes, while clinicians used desktop or laptop computers in offices without peripheral attachments or devices like stethoscopes, otoscopes or ophthalmoscopes.
Though the telehealth diagnosis was concordant with in-person care in 86.9% of cases overall, it did vary. The virtual diagnosis in specialty care cases agreed with the in-person decision in 88.4% of patients compared with only 81.3% in primary care. Concordance was lowest for otorhinolaryngology, or head and neck specialists, and highest in psychiatry.
“In diagnoses confirmed through clinician opinion, such as many psychiatric diagnoses, there was a significantly greater concordance between video telemedicine diagnosis and in-person diagnosis,” the study’s authors wrote. “In diagnoses necessitating confirmation through traditional physical examination, neurological testing and pathology — such as many otological and dermatological diagnoses — there was a significantly decreased concordance between video telemedicine and in-person diagnoses.”
Researchers also found the odds of diagnostic agreement decreased by 9% for every 10 year increase in the patient’s age. But concordance didn’t significantly vary between clinician types (such as physicians compared with advanced practice providers) and adult and pediatric patients, or based on length of consultation or how much experience a clinician had with video telehealth.
WHY IT MATTERS
Telehealth use surged during the COVID-19 pandemic as patients and providers sought to limit in-person interactions. Though utilization has changed since the height of the pandemic, FAIR Health’s Monthly Telehealth Regional Tracker found telehealth made up 5.4% of medical claim lines in May.
Researchers said one large takeaway from their study was the discrepancy between primary and specialty care, noting quicker in-person follow-up could be beneficial if primary care providers meet with patients virtually first.
“These findings suggest that video telemedicine visits to home may be good adjuncts to in-person care,” they wrote. “Primary care video telemedicine programs designed to accommodate new patients or new presenting clinical problems may benefit from a lowered threshold for timely in-person direct follow-up in patients suspected to have diseases typically confirmed by physical examination, neurological testing or pathology.”