Telemedicine was once seen primarily as a solution for remote or underserved populations. It is now widely recognized for its potential to enhance everyday care delivery. Telemedicine in primary care technologies includes remote monitoring, video consultations, and artificial intelligence (AI). These technologies offer new opportunities to provide efficient, accessible, patient-centered healthcare.
This article explores research into the value of telemedicine across primary care and how these solutions are helping with longstanding coordination and capacity issues.
The Rise of Telemedicine in Primary Care
When telemedicine in primary care is implemented properly, it can reduce the volume of in-person visits, which alleviates overcrowded clinics and gives patients timely care. Electronic health records (EHRs) can support telemedicine adoption but often have limitations, such as poor interfaces and adaptability. When telemedicine integrates electronic records (EHR) with artificial intelligence (AI), it can further enhance and maintain continuous care for patients with chronic illnesses like diabetes, hypertension, or heart disease.
One study, published in JAMA Network, summarized a physician’s experience with EHR as a primary care provider (PCP) in a federally qualified community health center. It highlighted how AI can assist PCPs by extracting information from hospital discharge summaries, reconciling medications, and identifying historical diagnoses from unstructured text. AI also prioritizes potential diagnoses based on radiology reports, saving time and improving accuracy.
However, communication within telemedicine consultations is equally important. A study published in BMC Primary Care explored the perspectives of general practitioners (GPs) and patients on the interactional aspects of telemedicine consultations. The study involved semi-structured interviews with 15 GPs and 9 patients, examining their preparation for telemedicine consultations, interactions, and post-consultation activities. Both GPs and patients identified key factors influencing whether a consultation would be best conducted via telemedicine or in-person, including the condition being discussed and the doctor-patient relationship.
The rise of telemedicine in primary care has prompted researchers to investigate its impact on healthcare delivery, including how it compares to traditional in-person visits in terms of electronic health record (EHR) usage and physician workload.
In-Person vs. Telemedicine in Primary Care EHR
A 2024 study published in JAMA Network Open examined the relationship between telemedicine use and electronic health record (EHR) time among primary care physicians (PCPs) at MedStar Health from December 2021 to June 2023. The research showed that the days of combining telemedicine in primary care and in-person visits were associated with significantly more EHR time compared to days with only in-person visits. Days with 26% to 99% telemedicine visits saw an increase of 14.8 minutes in active EHR time, including additional time for documentation and medical record review.
Interestingly, the increased EHR time on combined method days did not carry over to next-day documentation. This suggests the PCPs absorbed the added work on the same day. Fully telemedicine days were not associated with increased EHR time, though this was a small sample size.
The researchers hypothesize that the increased EHR time on telemedicine/In-person days might be due to increased multitasking during telemedicine visits, with PCPs engaging with patients and the EHR simultaneously in ways not possible during in-person visits. This suggests that integrating telemedicine into primary care practices may require adjustments to workflow and time management strategies.
Understanding Primary Care in Telemedicine
Telemedicine vs. in-person visits are performed differently in primary care. The integration of telemedicine into primary care has the potential to streamline healthcare delivery, improve PCP productivity, and enhance patient outcomes. AI-enhanced EHRs can support these advancements, but effective communication remains crucial. Studies like those published in JAMA Network and BMC Primary Care emphasize that while technology improves workflow efficiency, communication skills and patient factors such as familiarity with technology must be carefully considered to fully realize telemedicine’s potential in primary care.
When implemented effectively, telemedicine can offer solutions to long-standing issues in primary care, but continuous improvements in technology and communication practices are essential for its success.
