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Cosmos Study

Follow-Up Rates After Telehealth and Office Visits Steady in Last Three Years

January 9, 2024
Dual-Team Study
Team A:Kersten Bartelt, RNAlex Piff
Team B:Jackie Gerhart, MDEric Barkley

Key Findings

  • The rate of follow-up after an office visit or telehealth visit in the 7, 30, or 90 days after the initial encounter has stayed fairly consistent over the last three years. 
  • In most specialties, telehealth visits are more likely than office visits to have a follow-up within 7 days, but that gap narrows when looking at 30- or 90-day follow-up rates. 

We previously published a study that showed most specialties had a greater rate of same-specialty in-person follow-up within 90 days after an office visit than after a telehealth visit.1 To further understand follow-up patterns, we compared follow-up rates for telehealth and office visits in the 7, 30, and 90 days after the initial encounter. In contrast to our previous study, follow-up rates for this study include both telehealth and office visits. 

We studied telehealth and office visits between January 2020 and August 2023 to determine how often a same-specialty follow-up occurred. The follow-up visit could be either an office visit or a telehealth visit but must be in the same department specialty as the initial visit. Overall, the follow-up rate was under 40% for both telehealth and office visits within 90 days of the initial encounter, under 25% within 30 days, and under 10% within 7 days, as seen in Figure 1. These rates have remained steady since 2020. 

Figure 1
Follow-Up Rate After Telehealth and Office Visits
Follow-Up Rate After Telehealth and Office Visits
Figure 1. The rate of telehealth and office visits with follow-up over time.

We then stratified by department specialty for telehealth and office visits between July 2022 and August 2023 to evaluate patterns post-pandemic. We found that, compared to follow-up after office visits, follow-up within 90 days after a telehealth visit is more common in 13 department specialties of the 24 studied. Additionally, follow-up within 30 days and 7 days after a telehealth visit is more common in 14 and 17 department specialties, respectively. The top specialties with higher rates of follow-up after telehealth visits across all intervals included OB/GYN, podiatry, and primary care. The top specialties with higher rates of follow-up after office visits across all intervals included physical medicine and rehabilitation (PM and R), mental health, and sleep. 

Figure 2
Follow-Up Rates of Telehealth and Office Visits by Specialty
Follow-Up Rates of Telehealth and Office Visits by Specialty
Figure 2. The difference in rate of same-specialty follow-up in the 90, 30, and 7 days after telehealth and office visits.

These data come from Cosmos, a collaboration of 236 Epic health systems representing over 227 million patient records from 1,301 hospitals and more than 28,600 clinics from all 50 states and Lebanon. This study was completed by two teams that worked independently, each composed of a clinician and research scientists. The two teams came to similar conclusions. Graphics by Brian Olson. 

References

  1. Gerhart J, Piff A, Bartelt K, Barkley E. Fewer In-Person Follow-Ups Associated with Telehealth Visits Than Office Visits. Epic Research. https://epicresearch.org/articles/fewer-in-person-follow-ups-associated-with-telehealth-visits-than-office-visits. Accessed on December 1, 2023.