News Feature | April 18, 2016

All Telemedicine Services Not Created Equal

Katie Wike

By Katie Wike, contributing writer

Telehealth Dr. Video

A recent study has found varying quality in urgent care by commercial telehealth companies.

In nearly 600 virtual visits to leading commercial telehealth services, “patients” who were trained by researchers presented symptoms of six common acute illnesses. According to the results of the study, published by JAMA Internal Medicine, the quality of care provided in each of these situations varied greatly between each of the eight companies.

Fierce Health IT reports the ailments presented included ankle pain, potential strep, sore throat, sinus infection, low back pain, and urinary tract infections. The companies tested were Ameridoc, Amwell, Consult a Doctor, Doctor on Demand, MDAligne, MDLIVE, MeMD, and NowClinic.

Researchers found one in four patients got an incorrect or no diagnosis from the virtual visits. They also noted only 52 percent to 82 percent of the time virtual doctors got complete histories and did thorough exams. “One of the more surprising findings of the study was the universally low rate of testing when it was needed,” said lead researcher Dr. Adam Schoenfeld, of the University of California, San Francisco.

“We don’t know why, but it may reflect the challenges of ordering or following up on tests performed near where the patient lives but far from where the doctor is, or concern about the costs to the patient of additional testing,” Schoenfeld added via an email to Reuters.

In addition, researchers found standard care was given anywhere from 34 to 66 percent of the time. Virtual visits resulted in correct diagnoses only 65 percent to 94 percent of the time.

“Although virtual urgent care and in-person urgent care have not been compared head-to-head, virtual urgent care has its downsides – indirect physical exam, difficult access to testing, and unclear follow-up,” Dr. Jeffrey Linder, a researcher at Brigham and Women’s Hospital and Harvard Medical School who co-authored an editorial accompanying the study said by email. “While the quality of care is not perfect anywhere, a patient’s primary care doctor should be a person’s first point of contact.”