Telemedicine Has Declined Since Pandemic, but Video Encounters Still Frequent

Video- and telephone-based encounters accounted for 34.5 and 20.3 percent of mental health encounters by August 2023

By Elana Gotkine HealthDay Reporter

MONDAY, Jan. 22, 2024 (HealthDay News) — Telephone-based care has mainly resumed to prepandemic levels, while video-based care has remained elevated, according to a research letter published online Jan. 23 in the Annals of Internal Medicine.

Jacqueline M. Ferguson, Ph.D., from the Veterans Affairs Palo Alto Health Care System in Menlo Park, California, and colleagues describe trends in clinical outpatient encounters between Jan. 1, 2019, and Aug. 31, 2023, that took place in person, by telephone, and by video before, during, and after the pandemic. Data were included from 277,348,286 Veterans Affairs clinical outpatient encounters.

The researchers found that across all services, there was a sharp decrease in the number of in-person encounters at the start of the pandemic. Decreases in in-person primary care and mental health services were offset by an increase in telephone- and video-based encounters. In-person care became the primary modality among primary care services in January 2021, with a reversal of the increase in video and telephone encounters. Telephone- and video-based care decreased from a peak of 79.6 percent in April 2020 to 36.7 percent in April 2023 across all services. The decline was driven by fewer telephone encounters; however, the proportion of video encounters remained relatively stable (11 to 13 percent). Video-based encounters accounted for 34.5, 3.7, and 3.5 percent of mental health, subspecialty, and primary care encounters, respectively, by August 2023, while telephone encounters accounted for 20.3, 34.8, and 16.7 percent, respectively.

“Although these nationwide trends can inform research and policy, they obscure disparities in access to and use of telemedicine that disproportionately affect older adults, individuals in rural regions, and patients from historically marginalized groups,” the authors write.