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Podcast Library > NextGen Advisors Podcasts > Poll Results Confirm Patients' Demand for Telehealth and Online Healthcare Solutions

April 30, 2021

Poll Results Confirm Patients' Demand for Telehealth and Online Healthcare Solutions

Recently, NextGen Healthcare commissioned Harris Poll to conduct a survey of 2,055 adults ages 18 and older in order to understand the impact COVID-19 has had on the ways they received their healthcare and communicated with providers, as well as to gain insights into their experiences and preferences related to telehealth and online healthcare tools. This Advisors podcast is devoted to reviewing the findings and possible implications of the survey results.

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Transcript

Dr. Betty Rabinowitz:

Hello, this is Dr. Betty Rabinowitz, NexGen Healthcare's Chief Medical Officer and principal with NexGen Advisors. I'd like to welcome you to our podcast. I'm joined today, as usual, by my trusted colleagues, Graham Brown and Dr. Marty Lustick. Welcome, Graham and Marty.

Dr. Martin Lustick:

Hello Betty.

Graham Brown:

Hi Betty.

Dr. Betty Rabinowitz:

Recently, NexGen Healthcare commissioned an online survey within the United States by the Harris Poll Company that was conducted between March 25th and the 29th among 2,055 adults, age 18 and over, among whom 1,733 are patients defined as those who see a healthcare provider once a year or more often. The aim of this survey, which we called The Connected Healthcare Study, was to understand the impact of COVID-19 on healthcare and communication with providers, as well as gain insights into experiences and preferences as it relates to telehealth and online healthcare tools. Our podcast today will be devoted reviewing some of the highlights of the survey results. Let's get started. The first question of the survey seemed very straightforward. It asked, "Which of the following healthcare providers do you typically see in person or via telehealth once a year or more often?" And interestingly, more than four in five US adults, 84% typically in this survey, responded that they typically see a healthcare provider once a year, or more often, with most common provider type being primary care provider, 68%. Other providers Americans see once a year or more often included women's health provider. 33% of women responded that they see a women's health provider. 26% see an ophthalmologist. 18% see a mental health provider. 9% an orthopedist. And there were 14% in another category. So Marty, anything about these responses surprise you?

Dr. Martin Lustick:

Yeah, there were a few surprises for me here. One of them that the second most were, or I guess, third after the PCPs, that ophthalmologists are so high on the list here. That 26% of people actually go to an ophthalmologist on a regular basis. I was also a little surprised that the women's health provider was only 33%. It seems to me that a lot of women, especially those of childbearing age, tend to go to women's health providers, OB-GYNs, instead of their primary care doctor. And then the last thing that seemed a little bit odd when I first looked at it was that only 18% reported going to a mental health provider. But on second thought, the recent statistics during the pandemic showed that as many as 40% of the population is reporting depression or anxiety. Probably a lot of them are contacting their PCP and not a mental health provider with those issues if they're contacting anyone.

Dr. Betty Rabinowitz:

Absolutely, absolutely. In further kind of review of this response, the survey found that older adults are more likely to see doctors more frequently. Women with higher household income were more likely to see their OB-GYN more frequently, and younger patients are likely to see behavioral health providers. What are your thoughts on these findings, Graham?

Graham Brown:

To me it speaks to probably a more established relationship with a provider for these survey respondents. And there's kind of a recognition that at different age and income levels, there can be a correlation between a better understanding of healthcare and the role of preventive care as you age. As you've seen your physician more frequently you realize the value of it, and so you maintain that relationship. On the younger patients seeking behavioral healthcare, that to me is encouraging and kind of speaks to the destigmatization of behavioral health needs at a generational level. There's I think much less of a concern about society's opinion of you if you have mental health issues than there was a decade ago, and that younger patients are more willing and more adept at recognizing that's a need that they have, and they're going to get care for it.

Dr. Betty Rabinowitz:

That's interesting. Absolutely. So more than one in four, US patients, 27%, have missed an in-person appointment with the healthcare provider during the COVID 19 pandemic. And just under a quarter of US patients, 23%, have put off receiving follow-up medical care because they felt uncomfortable with seeing their healthcare provider in person due during the COVID pandemic. Marty, do these numbers support your understanding of the impact of COVID on routine preventive services?

Dr. Martin Lustick:

Somewhat. I think in terms of the percent of missed in-person appointments, that number really didn't surprise me. But having only 23% reporting that they put off receiving follow-up care when we know that about close to 50% of the population has a chronic disease in this country and the sort of routine preventive care that most of us are due for on an annual basis anyways, the number that I think has actually put off care is much higher than that 23%. So that surprised me a little bit, and putting off that care is going to, I think, have significant implications going forward.

Dr. Betty Rabinowitz:

To me, Marty, I agree with you. It seems that these numbers are quite low. I think that many of the respondents probably were not very proud of postponing care. And I wonder if they're underestimating the kinds of visits that they've missed, or the kinds of visits that they should have been actually coming to. I thought this number was quite low. When we asked patients about seeking a new healthcare provider, and if they were, what are the tools that they wanted their provider to offer or include. Online appointment scheduling. 49% felt that that was an important service. Respondents wanted the ability to check in or complete health forms appointment paperwork online before an appointment. About 50% of respondents asked for that. 48% wanted to be able to manage their prescriptions online. And 47% wanted access online to their medical records. Roughly two in five US patients say that digital communication capabilities, online bill payment, about 38% requested that. And 37% said telehealth appointments were extremely important to them. About a third of patients say that the ability to change or update health insurance online, about 34% said that that was important. 31% wanted to adjudicate online payment estimation. Those were some of the tools that patients felt were most important. So a very large array of capabilities. Graham, what do you feel are the strategic implications that these responses have if you were a CEO of a health information technology company like NextGen?

Graham Brown:

To me these results really validate the investments that NextGen has made in developing its platform. I think it speaks really to the importance of an integrated platform that can deliver a seamless experience to patients in the practices that they go to. Consumerism has become front and center of how people access care. I think the COVID 19 pandemic has really demonstrated that the practices that have these tools and provide them to patient are ahead of the game in really recognizing that that is a wave of the future that they need to be getting into. And so for a health information technology company, ensuring that those capabilities are available across all the different kind of healthcare markets that you're serving really seems to be the right strategy to be doubling down on and ensuring that it's a really comprehensive solution that has all the kind of tools and capabilities that practices are seeking. One of the interesting ones in particular was kind of low in my perspective, was 34% seeking online payment estimation, or sorry, 31% seeking that. So the ability to go in advance to a practice and understand what it's going to cost you out of pocket, what the fees are, I think is different maybe in the ambulatory world than it is if you're comparison shopping for a surgery. I doubt you can do that online. So that to me seems like an area that's going to continue to evolve as we get more transparency about the financial cost of seeking care and what the actual out of pocket is going to be for the individual, particularly if they're getting a procedure or a surgery. Less so for just a regular ambulatory patient visit.

Dr. Betty Rabinowitz:

Absolutely. And you know, what's exciting, Graham, is that the spring release that NextGen is coming out with does have a patient-facing estimator that allows people to actually see their out of pocket, based on their specific insurance policy and plan what they actually will be out of pocket for. I was struck by the breadth of the expectations in this area. This is no longer I want to be to email my physician a question. This is much broader, much deeper.

Graham Brown:

I want to be able to manage my healthcare through my phone and be able to coordinate all of my appointments and do it there a convenient time. And the practice needs to be responsive to that. So that practice needs to get those tools.

Dr. Betty Rabinowitz:

Absolutely. And along those lines, Marty, if you were a practice leader, what implications do these responses have for your strategy?

Dr. Martin Lustick:

Yeah, well, I think you've both made what for me is the key point here as well. As a leader of a practice, you can't look at these results and say, "Oh, okay, I need to add this capability to my electronic records so that people can and make appointments." There are half dozen different attributes that people are saying are among the most important things to them, that from a practice perspective, how do I incorporate all of these types of capabilities, not only in a way that is seamless for the patients, but also enables my providers to have a seamless workflow through the course of the day? And that's really the challenge for a practice, is if I have to meet these expectations of my patient population with a whole new set of capabilities, how do I incorporate them in a way that is integrated for my providers as well? So one-off solutions, this really begs against the idea of attempting any sort of one-off solutions for any one of these things.

Dr. Betty Rabinowitz:

Absolutely, absolutely. More than two third of respondents, 69%, have seen a healthcare provider via telehealth since the COVID pandemic began, with more than two in five, 46%, meeting with a PCP primary care provider. And about one in five, 19%, meeting with a mental health provider. Some other providers patients have seen since the pandemic began include women's health provider, about 15% of women. 9% saw an ophthalmologist virtually. And 7% saw an orthopedist virtually. Anything that surprises you in these numbers, Graham?

Graham Brown:

Not surprising per se. I think for me, it was really great to see how providers across specialties have modernized the tools that they deploy in practice to support good patient care, including deploying telehealth pretty rapidly in the past year. I think we anticipated that primary care and some of those appointments where a person with chronic needs might be able to see their provider through telehealth, you know, one in every three sessions and do the other ones in person. But what this really showed is that across specialties, there's an applicability for telehealth to be integrated into how patient care is provided. And that for practices that are looking to maintain that continuity with their patients during a very disruptive period of time that the pandemic was, telehealth was a really important tool for them to deploy rapidly and to be able to ensure that they could maintain continuity and address the care needs of those who might need it most.

Dr. Betty Rabinowitz:

Marty?

Dr. Martin Lustick:

Yeah. I don't know if surprise is the right word, but I think these results really reinforce. If this high of a percentage of people are using, have used, telehealth across this broader array of specialties, it really sends the message that it's here to stay, and that on the provider side, some of them that have come up with temporary solutions that might be allowed under the special rules of the pandemic really need to figure out what is their long term strategy and plan for enabling this channel of communication and interaction with their patients going forward.

Dr. Betty Rabinowitz:

Absolutely. So clearly telehealth may be the new normal. When we asked in the survey patients who received telehealth services since March, that was about 84% of the respondents said that they plan to continue using telehealth appointments in the future. They stated that the top reasons for them to do that was first and foremost, 43% of them said it was convenience. And another approximately 40% said that they felt the advantage was they didn't need to be around other ill people. Marty, if I told you two years ago, or 18 months ago, that this was the case, that 84% of patients plan to continue using telehealth, what would your response have been?

Dr. Martin Lustick:

That you're probably smoking something. It makes me laugh in one part, but I think back to when I was working in the health plan and we were trying to get our own employees to use telehealth when it was first started. We took iPads and we said, "If you register, you can be part of a raffle to win an iPad." We did all these advertisements just to get people to register to use the service. And we were able to get a little over half of the employees to register. But then when you looked at it a year later, less than 10% actually used the service in the course of the year. And now you look at these kind of numbers that happened organically, it's just incredible.

Dr. Betty Rabinowitz:

Graham?

Graham Brown:

I agree with Marty. I think what's interesting about the second part of this question is the rationale, the top reasons that people wanted to continue using telehealth. Convenience makes sense, but avoiding people that are ill, that 39% of individuals. That I don't think we would've seen two years ago. I think that to me really is a result of the pandemic and an awareness on individual's minds that if they go sit in a waiting room with 10 other individuals, that they might get exposed to something. I don't think that was on people's radar two years ago. It is now. And it's a factor certainly in why people are thinking telehealth is an important resource for them.

Dr. Betty Rabinowitz:

Absolutely interesting. I always thought waiting rooms were a Petri dish. But I could say as a physician, I would be expected to have known that before the general public acknowledged it. So one of the most striking results of the survey was that half of patients surveyed, 48%, have sought or would be likely to seek care from a different healthcare provider if their current provider did not offer telehealth appointments. So that is a striking result, that not only do people have a preference for their physician offering telehealth services, but that they would consider, or actually about 4% have already sought a different provider, or about 50% would seek a different provider if those telehealth services were not offered. What does this mean for provider across the country, Graham?

Graham Brown:

I think it means that patient-centered care is here to stay and practices need to adapt accordingly. I'm not sure we would've seen this level of patient loss in reality, but the writing's certainly on the wall in terms of meeting patients where they are. And what a strong force consumerism has shown to be, and really a major factor that leadership needs to consider in how they're serving their patients. Convenience is key at the end of the day. And if getting into your doctor and getting the care that you need in an accessible way isn't in the cards, then folks may indeed start looking elsewhere. So deploying these tools and making sure that you can serve patients the way they want to be served is a shift. It's kind of a paradigm shift, where for many years the practices were centered around what's convenient for the provider. And I think that really is shifting. It needs to be convenient for the patient, and the tools need to be there to serve patients in a way that's going to ensure that they're sticking to the practice.

Dr. Martin Lustick:

Yeah. I entirely agree with your point, Graham. Even though the telehealth component will be variable by specialty, you really generalized it to the broader point that it's not just about telehealth, even though that's what this question asked. It's about really meeting patients where they want to be met, and making their care easy for them to access. If providers don't look globally at sort of what is their patient engagement strategy and how do they make sure they're moving forward in that space, they're doing it at their own risk.

Dr. Betty Rabinowitz:

I think with that very clear call to action, we will end today. Our time is up. I'd like to thank you, our listeners, for joining today. And obviously as always, thank my colleagues, Dr. Marty Lustick and Graham Brown for sharing their insights and perspective on the results of the Harris Poll survey. If you enjoyed today's topic, consider subscribing to our podcast. This is Dr. Betty Rabinowitz with NextGen Healthcare. Have a great day.