How Has Telemedicine Adoption Changed? | 2020 Consumer Health Report Part 2
2020 Digital Health Consumer Adoption Report Overview
How has telemedicine adoption changed? The Rock Health and the Stanford Center for Digital Health produced the six annual Digital Health Consumer Adoption Report to understand how consumer behavior in 2020 compared to the five prior years of data collected. Since 2015, Rock Health has annually surveyed 4,000 consumers to understand consumer adoption of digital health technologies. For the 2020 report, the sample size was nearly doubled to allow for more in-depth subgroup analysis and the complete ability to measure consumer behavior changes in light of the pandemic.
During the five years leading up to 2020, the adoption of digital health steadily climbed. The pandemic accelerated adoption even further, and the rise continued. However, the rate of change in adoption differed by technology and by subgroup. One interesting note in the executive summary of the report is that though not a universal finding, some of the 2020 data suggest that the pandemic acted more to reinforce and accelerate underlying trends rather than to draw in new consumer subgroups as digital health users.
This is article two of four in a miniseries called Digital Health Consumer Adoption, where we examine the four key findings from the Rock Health|Stanford 2020 Consumer Adoption Report.
A Review of the Four Themes and Key Findings
The Rock Health|Stanford white paper explored four specific questions in regards to consumer adoption. The four questions, or Themes, are outlined below.
- Theme #1: How has telemedicine adoption changed? Telemedicine use before and during the pandemic.
- Theme #2: Who still hasn’t adopted telemedicine? Barriers to accessing telemedicine abound more than expected.
- Theme #3: How are consumers using digital health tracking tools differently during COVID-19? Unpacking the trends in health tracking and the use of wearables.
- Theme #4: How have consumers’ data-sharing preferences changed during the pandemic? A look at consumer trust and willingness to share health data.
Theme #1: How has telemedicine adoption changed? Telemedicine use before and during the pandemic.
Increased use in live video.
After leveling off between 2018 and 2019, live video care adoption increased 11% (from 32% to 43%) in 2020, indicating the significant and swift shift to live video.
Telemedicine is not reaching new demographic populations in significant numbers.
Those most likely to use telemedicine in 2020 remained consistent with past years: higher-income earners, middle-aged adults (aged 35-54), highly educated, and those with chronic conditions.
High consumer satisfaction.
But this may be just a relief to have an avenue of care during the pandemic. Satisfaction with live video visits was higher than in previous years. However, this could have been by the lack of a viable (or safe) alternative for an in-person visit.
The use of non-video forms of telemedicine is down.
Alongside the massive increase in reported live video use, fewer consumers reported using other telemedicine methods (e.g., live phone visits, text messaging, and email) than in past years.
Consumers used considerably less healthcare overall (both in-person and via telemedicine), lowering the number of consumers who reported using telemedicine in the survey.
The future of tech-enabled care models may not be revealed in how consumers are currently adopting telemedicine.
In 2020, the most common reason for accessing telemedicine was a medical emergency, and the most common channel was through a patient’s own doctor/clinician.
Four Components that Underpin and Drive Theme 1 | Changes in Telemedicine Adoption
Telemedicine user profiles in 2020 versus 2019
Health status & utilization are connected to telemedicine usage
Users in 2020
- Telemedicine users with at least one chronic condition – 78%
- High healthcare utilizers (6+ doctor visits in a year) – 87%
- Moderate utilizers (2-5 visits in a year) – 77%
- Low utilizers (0-1 doctor visits in a year) – 55%
Prescriptions & Telemedicine usage
- 4+ prescriptions & used telemedicine – 82%
- 1-3 prescriptions & used telemedicine – 76%
- 0 prescriptions & used telemedicine – 50%
In 2020, those between the age of 35-54 were the most likely adopters
- 35-54 years old – 78% used telemedicine in 2020
- 18-34 – 73% (vs 80% in 2019)
- 55+ – 59% (vs 71% in 2019)
Men were more likely to adopt than women
- Men – 74%
- Women – 66%
- Nonbinary – 67%
Higher-income earners were more likely to adopt telemedicine
- Incomes >$150K – 85%
- $35-75K – 65%
- <35K – 63%
Higher education linked to telemedicine use
- 86% – Graduate/Professional/Master’s/PhD
- 69% – Associate’s/Bachelor’s
- 63% – Some college without a degree
- 59% – High school graduates/did not complete high school
Urban areas had the highest adoption rate
- 79% – Urban
- 67% – Suburban
- 60% – Rural
Use did not vary dramatically across different racial and ethnic groups
Reasons Why Telemedicine Users Sought Care in 2020 Compared to 2019
As noted in the consumer adoption report, live video users with at least one chronic condition, the most common reason for seeking care was for a medical emergency (35% of all live video users). In contrast, respondents without a chronic condition mainly sought video care due to a minor illness (38% of all live video users).
Channels Used to Access Telemedicine Care
The Stanford/Rock Health Consumer Report noted that while all age groups were most likely to access telemedicine through their doctor/clinician, younger respondents were more likely than older respondents to access telemedicine through a service offered by their insurance company or an independent service.
Between 2019 and 2020, the most common pathway for live video and phone appointments was through a patient’s clinician/doctor. The tendency for clinicians grew remarkably in 2020, as many providers were expected to offer remote care.
2020: 70% of live video telemedicine users and 60% of live phone telemedicine users accessed telemedicine through their doctor
2019: 50% of live video users and 45% of phone users
Evaluating consumer satisfaction for telemedicine compared to in-person care
- Ninety percent of live video and 86% of live phone users were extremely or moderately satisfied with their visit.
- Just 4% of live video and phone telemedicine users were dissatisfied.
Satisfaction Compared to Past In-Person Interaction
- Satisfaction was highest for live video visits, followed by text message and picture or video.
- However, 19-34% of respondents were less satisfied with their virtual interaction than a previous in-person interaction, depending on the modality.
The Future Expectations of Telemedicine
- High satisfaction levels in 2020 may be a function of the circumstances created by the pandemic.
- On the other hand, high satisfaction in 2020 may presage a fundamental shift in consumer preference to virtual care models.
Researchers in the Rock Health|Stanford Consumer Adoption report imply that both of the above factors are at play.
The Future of Telemedicine
The future is a pro-active treatment model
- The bulk of telemedicine adoption in 2020 resembled the traditional synchronous, reactive, and episodic patient-provider care model.
Telemedicine needs to seek a different kind of customer
- As health plans and retail organizations become increasingly sophisticated in their virtual care offerings, it’s important to build the appropriate and financially sustainable type of utilization, which likely means building for chronic conditions and lower acuity care.
The next generation of healthcare consumers expect digital
- Patients are consumers. The opportunity for consumers to access care outside of their existing provider relationships is growing.
- Many consumers will prefer their existing physician, but the Stanford/Rock Health’s 2020 Consumer Adoption report data reinforced the degree to which younger consumers are more likely than their older counterparts to access telemedicine outside of their provide.