Telemedicine Revolution: Cutting Unnecessary Health Tests, Study Finds
Low-value care medical tests and procedures that provide little to no benefit to patients contribute to excess medical spending and both direct and cascading harm to patients. A research team from Mass General Brigham and their collaborators have found that telemedicine may help to reduce the use of low-value tests. The work is published in JAMA Internal Medicine.
“In theory, widespread adoption of telemedicine post-pandemic may influence low-value testing such as Pap smears and prostate cancer screenings in older adults, and imaging scans for straightforward cases of low back pain,” said lead author Ishani Ganguli, MD, MPH, of the Division of General Internal Medicine and Primary Care at Brigham and Women’s Hospital, a founding member of Mass General Brigham, and an Associate Professor of Medicine at Harvard Medical School. “But there was very limited evidence on this. We wanted to look at this question at a national level because there is active policy debate about whether and how Medicare should continue telemedicine coverage, hinging in large part on how telemedicine impacts care quality and spending.”
The results of the research showed that compared to patients in low-telemedicine systems, patients in high-telemedicine systems had slightly higher rates of total visits and lower use of 7 of 20 low-value tests: cervical cancer screening, screening electrocardiograms, screening metabolic panels, preoperative complete blood cell counts, preoperative metabolic panels, total or free triiodothyronine level testing for hypothyroidism, and imaging for uncomplicated low back pain. There were no significant differences in other tests.
The findings suggest that while virtual options may reduce barriers to care, telemedicine may also deter clinicians and patients from completing some low-value tests, especially tests like electrocardiograms and blood counts that would be done on-site during or just after an office visit.
Ref: Ganguli I et al. “Telemedicine Adoption and Low-Value Care Use and Spending Among Fee-for-Service Medicare Beneficiaries” JAMA Internal Medicine DOI: 10.1001/jamainternmed.2024.8354
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