Urgent and non-emergent telehealth care for seniors

 
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The quality and cost-effectiveness of telehealth for seniors – adults aged 60 and above – has been heavily debated in addition to being touted as an opportunity to avoid costly Emergency Department (ED) visits within the general population for low acuity or urgent care (UC) needs.15 An estimated 30% of all ED visits in the US are for non-urgent conditions, many of which can be addressed through telehealth.6 The pandemic coupled with the rise of direct-to-consumer (DTC) models of telehealth in recent years, providing on-demand access to online providers, has also accelerated its adoption.7
While recent COVID-19 events have put telehealth in the national spotlight, research on outcomes and utilization trends remains limited. The results are still mixed as to whether telehealth is effective in reducing downstream utilization (i.e., additional visits, procedures, etc.) One of the only studies addressing this issue found that while telehealth was convenient and increased access, it resulted in increased new utilization and no reduction in overall spending.8 In particular, Ashwood et al. found that up to 88% of telehealth services were for new utilization, suggesting telehealth led to additional follow-up visits or “episodes of care” with greater number of visits and calling into question its quality and cost-effectiveness.8 While Ashwood’s study focused on acute respiratory infections for a health maintenance organization in the United States, these findings suggest telehealth services, when delivered in a DTC model, increased utilization.
One area where telehealth may be impactful is in addressing the urgent and non-emergent healthcare needs of seniors. Urgent and non-emergent needs are typically defined as clinical conditions in which a short delay would not increase the likelihood of an adverse outcome (e.g. flu-like symptoms, skin rashes, fever, urinary tract infection (UTI), cough).
Studies have examined the impact of DTC models of telehealth and single-site studies have addressed the impact of telehealth on urgent and non-emergent needs of seniors; yet few, if any, multi-site studies have evaluated common outcomes across distinct telehealth delivery models. Our study aims to address the impact of telehealth services for urgent and non-emergent symptoms for seniors across three healthcare systems.

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