Telehealth in primary care risks fragmentation of patient info

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A new study suggests that the use of telemedicine in primary care could potentially lead to further fragmentation of care.

It’s possible that the use of the technology could lead to disconnected care, counteracting the benefits of improved patient access to care, contends Winston Liaw, MD, chairman of the Department of Health Systems and Population Health Sciences at the University of Houston’s College of Medicine.

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“Video visit platforms have their own electronic health records that may or may not communicate with the broader healthcare system,” says Liaw. “We have two systems operating in parallel that are completely distinct silos that have very little communication between them. We need to watch this closely.”

Liaw and his colleagues conducted a web-based survey of adults with access to telehealth services through LiveHealth Online, a telemedicine platform operated by Anthem Blue Cross. Results of the study, purportedly the first to assess the relationship between telehealth use and access to primary care, were published last week in the Journal of the American Medical Informatics Association.

“Telehealth users reported that they relied on live video for enhanced access and were less connected to primary care than nonusers were,” the study’s authors conclude. “Telehealth may expand service access but risks further fragmentation of care and undermining of the primary care function absent better coordination and information sharing with usual sources of patients’ care.”

The study notes the fact that on average Medicare beneficiaries see seven physicians at four different practices, leading to duplicate services, conflicting advice and ultimately inefficiently delivered care.

To enhance access without sacrificing coordination, the authors contend that telehealth “will need to share information with primary care and vice versa” and that “without adequate sharing, errors can occur, and critical information will not be communicated to others.”

“We hope this is a wake-up call for our healthcare system, where we will embrace the access benefit of telehealth and balance it with coordinated care,” adds Liaw.

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