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UPJ INSIGHT Telemedicine Utilization in the COVID-19 Era: Patterns of Care in Community Urology Practice
By: Robert A. Dowling, MD, Dowling Medical Director Services, Fort Worth, Texas; Song Zhang, PhD, University of Texas Southwestern Medical Center, Dallas; Evan Goldfischer, MD, Premier Medical Group of the Hudson Valley, Poughkeepsie, New York; David M. Albala, MD, Downstate Health Sciences University, Brooklyn, New York Associated Medical Professionals, Syracuse, New York; Alex Bart, Associated Medical Professionals, Syracuse, New York | Posted on: 20 May 2024
Dowling RA, Zhang S, Goldfischer E, Albala DM, Bart A. Telemedicine utilization in the COVID-19 era: patterns of care in community urology practice. Urol Pract. 2024;11(3):474-485. doi:10.1097/UPJ.0000000000000523
Study Need and Importance
Telemedicine was adopted rapidly in response to the COVID-19 pandemic, but its future role in the care of urologic patients is uncertain. We set out to determine the characteristics of telemedicine adoption in independent urology practices before, during, and after the acute phase of the pandemic. These findings may contribute to understanding the appropriate role of telemedicine in urologic practice.
What We Found
Telehealth eligible encounters declined sharply from a prepandemic baseline of 262 per provider per month (pppm) to a nadir of 164 pppm in April 2020 (acute phase), but quickly rebounded to 264 pppm by June 2020 (postacute phase). Telehealth adoption among urology providers in this study was 0% prior to March 2020, peaked at 46% in April 2020, and then declined to a stable rate of 3% of eligible encounters (Figure). Telehealth adoption was higher in female patients, patients less than 75 years old, and those with commercial insurance. Patients with 1 or more telehealth encounters had higher utilization and costs than patients who did not have a telehealth encounter. Overall utilization and cost did not increase with telehealth use.
Limitations
Our data are limited to practice level claims and may not accurately reflect costs of entire treatment episodes. While our dataset is very large, findings from these independent urology practices may not be generalizable to all practices.
Interpretation for Patient Care
The low but sustained rate of telehealth use suggests a limited but enduring role in the care of patients with certain diagnoses and without any concern about overutilization.
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