Cover: Analysis of Teladoc Use Seems to Indicate Expanded Access to Care for Patients Without Prior Connection to a Provider

Analysis of Teladoc Use Seems to Indicate Expanded Access to Care for Patients Without Prior Connection to a Provider

Published in: Health Affairs, v. 33, no. 2, Feb. 2014, p. 258-264

Posted on RAND.org on February 01, 2014

by Lori Uscher-Pines, Ateev Mehrotra

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Research Questions

  1. How did Teladoc (a large, national telemedicine provider) influence use of health care services?

Despite the potential benefits of telehealth applications, little is known about their overall impact on care. This is critical because rising health care costs and a shortage of primary care providers make it likely that telehealth services will play an increasingly important role in health care delivery. To help fill this gap in knowledge, we describe early experiences with Teladoc, one of the largest telemedicine providers in the United States, which provides care directly to patients over the telephone or via the Internet. We analyzed claims data for a large California agency serving public employees that recently offered Teladoc as a covered service. The 3,701 Teladoc "visits" we studied were for a broad range of diagnostic categories, the most common of which were acute respiratory conditions, urinary tract infections, and skin problems. Compared to patients who visited a physician's office for a similar condition, adult Teladoc users were younger and less likely to have used health care before the introduction of Teladoc. Patients who used Teladoc were less likely to have a follow-up visit to any setting, compared to those patients who visited a physician's office or emergency department. Teladoc appears to be expanding access to patients who are not connected to other providers. Future research should assess the impact of Teladoc and other telehealth interventions on the quality and cost of care.

Key Findings

  • Teladoc appeared to expand access to care, as more than 20 percent of those who used Teladoc had not seen a health care provider in the prior year.
  • The conditions most commonly treated via Teladoc were acute respiratory conditions, urinary tract infections, and skin problems.
  • Compared to patients who visited a doctor's office for similar conditions, patients who used Teladoc were younger, healthier, and lived in more affluent communities.
  • Only six percent of Teladoc patients required a follow-up visit for a similar problem, and Teladoc patients were less likely to have a follow-up as compared to patients who visited other settings, providing some evidence that Teladoc resolved patients' complaints.

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