Telehealth Adoption 
Tracker

From The Chartis Group and Kythera Labs

Copyright © 2021 The Chartis Group, LLC. All rights reserved.

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The Chartis Group and Kythera Labs have brought together a team of data scientists, visualization experts and industry thought leaders to develop the Telehealth Adoption Tracker, an advanced analytic tool designed to measure how COVID-19 has driven rapid telehealth adoption across the country. The Telehealth Adoption Tracker allows a user to analyze how geographies and specialties have been impacted by the rapid switch to telehealth over time.

This interactive tool allows users to filter by geographic and market level dimensions – exploratory functionality is available throughout the dashboard to isolate to segments of interest. Data will be refreshed on a routine basis as we continue to monitor and track telehealth adoption and its impact on the healthcare ecosystem.

Analytics Methodology

Underlying data provided by Kythera Labs are sourced from clearinghouse claims vendors which comprise a national representation of submitted professional medical claims. These claims include self-insured and fully insured health plans across most major commercial payors and Medicare Advantage. The level of claims coverage varies by geography. Geographic and specialty utilization patterns may change over time based upon timing and mix of claims reporting by clearinghouse. Data is refreshed on a weekly basis, which includes data for the subsequent week, in addition to newly submitted claims from prior weeks.

Effective July 2020: Modified methodology has been implemented for geographic analysis, now defined based upon patient location.

Data excludes providers billing from US territories: Puerto Rico, Guam and the Virgin Islands. Telehealth adoption rates for multi-state CBSAs will aggregate into the respective telehealth adoption rate calculation, identified and assigned by the respective provider state. Physician specialties are determined based upon the specialty assigned to the rendering provider NPI. Certain physician specialties are combined or excluded to form the 20 specialties reported in the analysis. APP-defined practitioners have been excluded from this analysis. Percentage telehealth rate is calculated as the ratio of unique telehealth visits as a proportion of total physician visits.

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View Data Trends & Insights

Click below to view previous telehealth adoption insights — including the 6 key areas of telehealth adoption trends over the last year.

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Previous Telehealth Adoption Trends
Published August 6, 2020 

National telehealth utilization has stabilized.
Telehealth made up 18 percent of all physician visits during the week beginning July 20. This is the sixth straight week that telehealth utilization has remained between 18 and 20 percent of all visits — well down from a peak of 50 percent in mid-April — indicating that this range may represent a “new normal” during the COVID-19 period and under the current telehealth regulatory and reimbursement rules.

If you would like to learn more about work by The Chartis Group and Kythera Labs regarding telehealth and demand recovery across the healthcare ecosystem, please contact us.

Meanwhile, telehealth adoption rates within COVID-19 “hot-spot” states rose.
Countering the national trend, telehealth rates increased in many states that experienced the biggest spikes in COVID-19 cases from mid-June through mid-July. Florida (21 percent telehealth adoption rate), Texas (23 percent) and Arizona (21 percent) saw telehealth utilization rates increase by 4 to 6 points since mid-June and each state now sits above the national telehealth average.

The urban and rural telehealth divide is pronounced and shows signs of widening. 
Rates of telehealth use in urban areas have exceeded those in rural geographies since the beginning of the pandemic. The telehealth adoption rate for primary care visits was 28% higher in urban geographies than rural ones in the most recent week of data. While overall telehealth adoption has stabilized recently, the urban-rural telehealth divide has widened since the early weeks of the pandemic—up from an 18% differential during the peak telehealth adoption weeks in mid-April.

Telehealth has predominantly functioned as a modality to manage established patients.
New patients represent just 5 percent of overall telehealth visits, compared to 13 percent of in-person visits throughout the COVID period indicating that virtual care modalities to date have been primarily utilized as tools to manage care for established patients. Finding ways to leverage telehealth to expand access to new patients will be a key driver of telehealth’s continued adoption and growth.

Chartis and Kythera Labs are continuing to monitor telehealth adoption and utilization across the US and post our weekly Telehealth Adoption Tracker to enable drill-down analysis of specific markets. We recently refreshed our data through the week of July 20th and examined the emerging and abating trends. Here are a few highlights reflecting the latest data-driven findings.

Prior to the COVID-19 outbreak, telehealth visits represented less than 1 percent of all physician visit volumes. By the fourth week of April 2020, 42 percent of all physician visits nationwide were being performed via telehealth. COVID-19 has ushered in a new era for telehealth, accomplishing in weeks what many thought would take years. Not unexpectedly, telehealth adoption is not uniform across regions, specialties or consumer segments. Analyzing trends over the last six weeks raises three important considerations for providers regarding the long-term role telehealth will play in the care delivery ecosystem, which are shared in this report:

DOWNLOAD REPORT FROM MAY 2020

Telehealth: Current Trends and Long-Term Implications
A joint thought leadership perspective by The Chartis Group and Kythera Labs
Published May 22, 2020

Telehealth growth will stabilize as physician offices reopen, but remain an essential component of care delivery.

Telehealth will impact every physician specialty—from primary care to medical and surgical disciplines. 

Telehealth’s impact on health disparities must be understood and addressed.

As the telehealth landscape continues to evolve, we will continue to monitor the trends to answer key questions, including: When will telehealth visits level out and form a new status quo? Which specialties will continue to see higher levels of telehealth adoption in the long term? How is telehealth addressing or exacerbating health disparities between geographic, socioeconomic, racial/ethnic and other population segments?

Telehealth for Pediatric Populations
Telehealth utilization varies for like-specialties in pediatric vs. adult populations. For example, during the week of April 11th, neurology specialists saw pediatric telehealth utilization spike to 79 percent vs. only 63 percent in the adult population. Notably, pediatric neurology telehealth utilization only declined to 69 percent, as compared to 46 percent for adults in the most recent week of data. Similar patterns are occurring across several other pediatric medical specialties, including gastroenterology and pulmonology.

Behavioral Health as a Telehealth Champion
Behavioral health has shown more resilience in sustaining telehealth utilization than have other specialties. As physician visit volumes for behavioral health/psychiatry begin to return, telehealth adoption is continuing to build momentum, reaching 64 percent as of mid-May. This suggests this specialty may have turned a corner in how to effectively embed telehealth within care models.

Telehealth Adoption Varies by Market
As noted in our original article, we’ve seen telehealth adoption trends vary by market based upon COVID-19 incidence and state and local guidelines for stay-at-home orders. Markets that reopened more quickly such as Dallas and Jacksonville  saw adoption decline to 25 percent and 17 percent, respectively, whereas markets with a higher incidence of COVID-19 remained above the national average of telehealth adoption through mid-May,such as Detroit (42 percent) and New York City–Newark (45 percent).

Decreasing Utilization of Telehealth
Not unexpectedly, while total physician visit volumes are beginning to recover as practices reactivate, the relative proportion of telehealth visits is beginning to decline. By the week of May 18th, telehealth adoption declined to 29 percent (from a peak of 47 percent) of total physician visit volumes. This proportional shift is a result of both a significant increase in in-person care as well as decreased telehealth utilization in certain specialties.

Chartis and Kythera Labs are continuing to follow trends in telehealth adoption across the country. With the most recent data available through May 18, after an initially rapid expansion of telehealth in the first phase of COVID, we are starting to see some decline in telehealth adoption as shelter-in-place orders are starting to lift and phased reopening plans are initiated.  A few highlights regarding what this latest data shows include:

Previous Telehealth Adoption Trends
Published June 18, 2020 

We reviewed 6 key areas of telehealth adoption to identify emerging trends in the first year of data:

GEOGRAPHY
Are there patterns of greater adoption in certain regions of the country? Does adoption follow local or regional spikes in COVID-19 infection rates?

Explore Data & Insights

PATIENT DEMOGRAPHICS
Are there patterns among different age groups of patients accessing telehealth visits?

Explore Data & Insights

NEW VS. ESTABLISHED PATIENT VISITS
Are telehealth volumes more from follow-up visits or initial consults? Are there notable distinctions between new and established patient telehealth visits?

Explore Data & Insights

PRIMARY CARE AND SPECIALTY TELEHEALTH VISITS
Are there patterns regarding what type of visits (e.g., primary care, medical specialties, surgical specialties) are being accessed via telehealth platforms?

Explore Data & Insights

CLINICAL SERVICE LINE ADOPTION
Which clinical service areas have shown the greatest sustainability in telehealth adoption? Are there similarities or distinctions between adoption curves of those service areas?

Explore Data & Insights

Detailed observations and practical implications in each of these six key areas are discussed in the full report.

AGGREGATE DEMAND & SUBSTITUTION EFFECTS
As telehealth visits began to subside in the late spring of 2020, what did the growth pattern of in-person visits look like? Has overall aggregate demand for clinical services risen or fallen in the last year?

Explore Data & Insights
Download the Full Report

JAN 1, 2020 – JAN 25, 2021

Telehealth Adoption Steadying Toward a New Normal Rate
Published September 8, 2021 

Analysis Summary

More than a year into the COVID-19 pandemic, the long-term role of telehealth as a permanent fixture of care delivery models is starting to crystalize. While we have seen fluctuations in the overall adoption of telehealth (primarily video visits*), which has largely tracked with the initial surge and subsequent spikes in COVID-19 cases, providers are beginning to realize that telehealth is not a mere backup plan to revert to only during the pandemic. Sustained adoption well above pre-pandemic levels are likely to persist — and even grow — as providers increasingly leverage telehealth capabilities as a means not only to operationally survive but to competitively thrive.

This tool uses several million claims records from Jan. 1, 2020, through May 7, 2021, to track telehealth adoption trends since the beginning of the pandemic to identify where we see the greatest impact — and infer where it is likely to remain in the future. Distinctive pockets of sustained adoption are emerging, like behavioral health, which have become truly transformed care models over the last year and a half. Primary care and some medical specialties are also expanding their experimentation with integrating telehealth into their care delivery platforms in a more deliberate way.  

We will be refreshing this dataset as notable trends emerge and warrant corresponding commentary and insight. For instance, the downward trends in telehealth adoption during the spring months of 2021 are expected to reverse somewhat during the summer months as we've seen the spread of the Delta variant subsume gains made as vaccinations became more common. The springtime downward trend is also likely reflective of pent-up demand for in-person visits postponed during 2020.

Looking ahead to the latter half of 2021, telehealth adoption likely will see short-term spikes and falls based on factors like new COVID variants (including Delta and other common strains) and regulatory changes, such as payment waiver expiration. Longer term, telehealth adoption growth will be driven by a combination of providing a compelling user experience for patients and providers alike, as well as its integration into the care continuum such that handoffs between virtual and in-person teams is seamless, standardized, and streamlined to maximize efficiency and outcomes that will attract and retain patient relationships for the foreseeable future.

*Data reported includes the following types of telehealth services:

New/Established Virtual 77.93%
Audio Only 18.14%
Virtual Check-in 1.71%
Online Digital E/M 1.69%
Telephone 0.49%
Non-Physician Online A/M 0.04%
Other/Invalid 0.00%