Research ArticleORIGINAL RESEARCH

Capacity of Primary Care to Deliver Telehealth in the United States

Anuradha Jetty, Yalda Jabbarpour, Matthew Westfall, Douglas B. Kamerow, Stephen Petterson and John M. Westfall
The Journal of the American Board of Family Medicine February 2021, 34 (Supplement) S48-S54; DOI: https://doi.org/10.3122/jabfm.2021.S1.200202

Article Figures & Data

Figures

Tables

  • Table 1.

    Distribution of Patient-Physician Encounters by Patient Characteristics and Telehealth Amenability

    Telehealth AmenableP Value
    CharacteristicsnYes (Weighted %)No (Weighted %)
    Age, y0 to 17169939.161.9.02
    18 to 34173942.058.0
    35 to 44115437.162.9
    45 to 54162833.866.2
    55 to 64214033.266.8
    65p432029.871.2
    SexMale556735.364.7.91
    Female711335.164.9
    Race/ethnicityWhite, Non-Hispanic923136.763.3.24
    Black, Non-Hispanic114229.861.2
    Other, Non-Hispanic60330.469.6
    Hispanic170433.866.2
    Insurance coveragePrivate10,55335.164.9.56
    Public523333.067.0
    Chronic conditionsAsthma78230.569.5.064
    Diabetes88731.968.1.30
    Hypertension356731.069.0.021
    Hyperlipidemia200435.964.1.77
    Depression110044.955.1<.001
    Coronary Artery Disease80424.775.3.010
    Number of Chronic Conditions23032.12.4<.001

    • Source: Author’s analysis of the 2016 National Survey of Ambulatory Medical Care Survey weighted by patient weight (n = 12,680, equivalent to 850,695,621 patient-physician encounters).

  • Table 2.

    Proportion of Patient-Physician Encounters Amenable to Telehealth

    Telehealth Amenable EncountersAll PhysiciansPrimary Care Physicians
    n%n%
    Yes299,347,45335165,333,98442
    No551,348,16865228,884,01758
    Total850,695,621100394,218,001100

    • Source: Author’s Analysis of the 2016 National Survey of Ambulatory Medical Care Survey weighted by patient weight.

    • *Telehealth amenable encounter was coded as ‘0’ when at least one of the services required physical presence of the physician and ‘1’ if physical presence was not required.

  • Table 3.

    Proportion of Services Amenable to Telehealth

    All Office-Based VisitsPrimary Care Visits
    Telehealth Amenable Servicesn%n%
    Yes208,347,00170120,922,77073
    No91,000,4523044,411,21427
    Total299,347,453165,333,984

    • Source: Author’s analysis of the 2016 National Survey of Ambulatory Medical Care Survey weighted by patient weight.

    • *Telehealth amenable services means all services rendered at a given visit can be delivered via telehealth.

  • Physical Presence required (Telehealth Capacity = 1)
    Examination/ScreeningLab TestsImagingTreatmentsHealth Education/Counseling
    Alcohol misuse screeningBasic Metabolic PanelAny Image
    Depression screeningCBCBone Mineral densityAlcohol abuse counseling
    Domestic violence screeningChlamydia TestCT ScanAsthma education
    Substance abuse screeningComprehensive metabolic panel (CBP)EchocardiogramAsthma action plan given to patient
    SkinCreatinine/Renal Function PanelOther UltrasoundMental health counseling, excluding psychotherapyDiabetes education
    Culture, bloodMammographyDiet/Nutrition
    Culture, throatMRIExercise
    Culture, urineRadiographPsychotherapyFamily planning/Contraception
    Culture, otherOther ImagingGrowth/development
    Glucose, serumInjury prevention
    Gonorrhea testSTD prevention
    HbA1c (Glycohemoglobin)Stress management
    Hepatitis testing/panelSubstance abuse counseling
    HIV testTobacco use/Exposure
    HPV DNA testWeight reduction
    Lipid profile/panelOther services
    Liver enzymes/Hepatic function panel
    Pregnancy/HCG test
    PSA
    Rapid Strep test
    TSH/Thyroid
    Urine analysis/Urine dip stick
    Vitamin D test
    Cholesterol
    Triglycerides
    Fasting blood glucose
    Physical Presence required (Telehealth Capacity = 0)
    Examination/ScreeningProceduresLab TestsTreatments
    Breast ExamAudiometryPap testCast/splint/wrap
    Foot ExamBiopsy providedComplementary and alternative medicine (CAM)
    NeurologicCardiac stress testDurable medical equipment
    PelvicColonoscopyHome health care
    RectalCryosurgery(cryotherapy)/destruction of tissue
    RetinalEKG/ECGOccupational therapy
    Electroencephalogram (EEG)Physical therapy
    Electromyogram (EMG)
    Excision of tissue providedRadiation therapy
    Fetal monitoringWound care
    Peak flow
    Sigmoidoscopy provided
    Spirometry
    Tonometry
    Tuberculosis skin testing (PPD)
    Upper gastrointestinal endoscopy/EGD provided

    • CBC, Complete blood count; HPV, human papillomavirus; HCG, human chorionic gonadotrophin; HIV, human immunodeficiency virus; TSH, thyroid-stimulating hormone; MRI, magnetic resonance imaging; STD, sexually transmitted disease; EKG/ECG, electrocardiogram; PPD, purified protein derivative (TB test); EGD, esophagogastroduodenoscopy.

  • Appendix 2. Literature Support for Services Amenable to Telehealth (Telehealth Capacity = 1)

     Relevant Literature
    ServiceFeasible/SupplementaryEffectiveComparatively EffectiveCost EffectiveOverview
    General    Bashshur RL, Howell JD, Krupinski EA, Harms KM, Bashshur N, Doarn CR. The Empirical Foundations of Telemedicine Interventions in Primary Care. Telemed J E Health. 2016;22(5):342 to 375. doi:10.1089/tmj.2016.0045
      Tuckson RV, Edmunds M, Hodgkins ML. Telehealth. New England Journal of Medicine. 2017;377(16):1585 to 1592. doi:10.1056/NEJMsr1503323
      Totten AM, Womack DM, Eden KB. Telehealth: mapping the evidence for patient outcomes from systematic reviews. Technical brief no. 26. Rockville, MD: Agency for Healthcare Research and Quality, June 2016
    Examination/Screening  
     Alcohol misuse screeningTofighi B, Abrantes A, Stein MD. The Role of Technology-Based Interventions for Substance Use Disorders in Primary Care: A Review of the Literature. Med Clin North Am. 2018;102(4):715 to 731. doi:10.1016/j.mcna.2018.02.011 
     Molfenter T, Brown R, O'Neill A, Kopetsky E, Toy A. Use of Telemedicine in Addiction Treatment: Current Practices and Organizational Implementation Characteristics. Int J Telemed Appl. 2018;2018:3932643. Published 2018 Mar 11. doi:10.1155/2018/3932643 
     Ríos-Bedoya CF, Hay C. Feasibility of using text messaging for unhealthy behaviors screening in a clinical setting: a case study on adolescent hazardous alcohol use. J Am Med Inform Assoc. 2013;20(2):373 to 376. doi:10.1136/amiajnl-2011-000688 
     Depression screeningWang K, Varma DS, Prosperi M. A systematic review of the effectiveness of mobile apps for monitoring and management of mental health symptoms or disorders. J Psychiatr Res. 2018;107:73 to 78. doi:10.1016/j.jpsychires.2018.10.006Kingston D, Austin MP, Veldhuyzen van Zanten S, et al. Pregnant Women's Views on the Feasibility and Acceptability of Web-Based Mental Health E-Screening versus Paper-Based Screening: A Randomized Controlled Trial. J Med Internet Res. 2017;19(4):e88. Published 2017 Apr 7. doi:10.2196/jmir.6866 
     Abd-Alrazaq AA, Alajlani M, Alalwan AA, Bewick BM, Gardner P, Househ M. An overview of the features of chatbots in mental health: A scoping review. Int J Med Inform. 2019;132:103978. doi:10.1016/j.ijmedinf.2019.103978 
     Domestic violence screeningBacchus LJ, Bullock L, Sharps P, et al. Infusing Technology Into Perinatal Home Visitation in the United States for Women Experiencing Intimate Partner Violence: Exploring the Interpretive Flexibility of an mHealth Intervention. J Med Internet Res. 2016;18(11):e302. Published 2016 Nov 17. doi:10.2196/jmir.6251Constantino RE, Braxter B, Ren D, et al. Comparing Online with Face-to-Face HELPP Intervention in Women Experiencing Intimate Partner Violence. Issues in Mental Health Nursing. 2015;36(6):430 to 438. doi:10.3109/01612840.2014.991049. 
     Hassija C, Gray MJ. The Effectiveness and Feasibility of Videoconferencing Technology to Provide Evidence-Based Treatment to Rural Domestic Violence and Sexual Assault Populations. Telemedicine and e-Health. 2011;17(4):309 to 315. doi:10.1089/tmj.2010.0147. 
     Substance abuse screeningMolfenter T, Brown R, O'Neill A, Kopetsky E, Toy A. Use of Telemedicine in Addiction Treatment: Current Practices and Organizational Implementation Characteristics. Int J Telemed Appl. 2018;2018:3932643. Published 2018 Mar 11. doi:10.1155/2018/3932643McKellar J, Wagner T, Harris A, Oehlert M, Buckley S, Moos R. One-year outcomes of telephone case monitoring for patients with substance use disorder. Addict Behav. 2012;37(10):1069 to 1074. doi:10.1016/j.addbeh.2012.03.009 
     Skin Lee KJ, Finnane A, Soyer HP. Recent trends in teledermatology and teledermoscopy. Dermatol Pract Concept. 2018;8(3):214 to 223. Published 2018 Jul 31. doi:10.5826/dpc.0803a13 
      Trettel A, Eissing L, Augustin M. Telemedicine in dermatology: findings and experiences worldwide - a systematic literature review. Journal of the European Academy of Dermatology and Venereology. 2017;32(2):215 to 224. doi:10.1111/jdv.14341. 
    Lab Tests***Telehealth delivery of lab test results is common practice 
    Imaging***Telehealth delivery of imaging results is common practice 
    Treatments  
     Mental health counseling/PsychotherapyGoetter EM, Blackburn AM, Bui E, Laifer LM, Simon N. Veterans Prospective Attitudes About Mental Health Treatment Using Telehealth. Journal of Psychosocial Nursing and Mental Health Services. 2019;57(9):38 to 43. doi:10.3928/02793695 to 20190531-02.Barrera TL, Cummings JP, Armento M, et al. Telephone-Delivered Cognitive-Behavioral Therapy for Older, Rural Veterans with Depression and Anxiety in Home-Based Primary Care. Clinical Gerontologist. 2016;40(2):114 to 123. doi:10.1080/07317115.2016.1254133.Kalapatapu RK, Ho J, Cai X, Vinogradov S, Batki SL, Mohr DC. Cognitive-behavioral therapy in depressed primary care patients with co-occurring problematic alcohol use: effect of telephone-administered versus face-to-face treatment-a secondary analysis. J Psychoactive Drugs. 2014;46(2):85 to 92. doi:10.1080/02791072.2013.876521Egede LE, Dismuke CE, Walker RJ, Acierno R, Frueh BC. Cost-Effectiveness of Behavioral Activation for Depression in Older Adult Veterans. The Journal of Clinical Psychiatry. 2018;79(5). doi:10.4088/jcp.17m11888. 
     Massoudi B, Holvast F, Bockting CL, Burger H, Blanker MH. The effectiveness and cost-effectiveness of e-health interventions for depression and anxiety in primary care: A systematic review and meta-analysis. Journal of Affective Disorders. 2019;245:728 to 743. doi:10.1016/j.jad.2018.11.050.Mohr DC, Ho J, Duffecy J, et al. Effect of telephone-administered vs face-to-face cognitive behavioral therapy on adherence to therapy and depression outcomes among primary care patients: a randomized trial. JAMA. 2012;307(21):2278 to 2285. doi:10.1001/jama.2012.5588Watzke B, Haller E, Steinmann M, et al. Effectiveness and cost-effectiveness of telephone-based cognitive-behavioral therapy in primary care: study protocol of TIDe - telephone intervention for depression. BMC Psychiatry. 2017;17(1):263. Published 2017 Jul 19. doi:10.1186/s12888-017-1429-5 
     Barrera TL, Cummings JP, Armento M, et al. Telephone-Delivered Cognitive-Behavioral Therapy for Older, Rural Veterans with Depression and Anxiety in Home-Based Primary Care. Clinical Gerontologist. 2016;40(2):114 to 123. doi:10.1080/07317115.2016.1254133.Morriss R, Patel S, Malins S, et al. Clinical and economic outcomes of remotely delivered cognitive behavior therapy versus treatment as usual for repeat unscheduled care users with severe health anxiety: a multicenter randomized controlled trial. BMC Med. 2019;17(1):16. Published 2019 Jan 23. doi:10.1186/s12916-019-1253-5Morriss R, Patel S, Malins S, et al. Clinical and economic outcomes of remotely delivered cognitive behavior therapy versus treatment as usual for repeat unscheduled care users with severe health anxiety: a multicenter randomized controlled trial. BMC Med. 2019;17(1):16. Published 2019 Jan 23. doi:10.1186/s12916-019-1253-5 
      Egede LE, Dismuke CE, Walker RJ, Acierno R, Frueh BC. Cost-Effectiveness of Behavioral Activation for Depression in Older Adult Veterans. The Journal of Clinical Psychiatry. 2018;79(5). doi:10.4088/jcp.17m11888. 
      Kirkness CJ, Cain KC, Becker KJ, et al. Randomized trial of telephone versus in-person delivery of a brief psychosocial intervention in post-stroke depression. BMC Res Notes. 2017;10(1):500. Published 2017 Oct 10. doi:10.1186/s13104-017-2819-year 
      Kivelitz L, Kriston L, Christalle E, et al. Effectiveness of telephone-based aftercare case management for adult patients with unipolar depression compared to usual care: A randomized controlled trial. PLoS One. 2017;12(10):e0186967. Published 2017 Oct 27. doi:10.1371/journal.pone.0186967 
    Health education/Counseling  
     Alcohol abuse counselingGustafson DH, McTavish FM, Chih MY, et al. A smartphone application to support recovery from alcoholism: a randomized clinical trial. JAMA Psychiatry. 2014;71(5):566 to 572. doi:10.1001/jamapsychiatry.2013.4642Kalapatapu RK, Ho J, Cai X, Vinogradov S, Batki SL, Mohr DC. Cognitive-behavioral therapy in depressed primary care patients with co-occurring problematic alcohol use: effect of telephone-administered versus face-to-face treatment-a secondary analysis. J Psychoactive Drugs. 2014;46(2):85 to 92. doi:10.1080/02791072.2013.876521 
     Asthma education/action plan Locke ER, Thomas RM, Woo DM, et al. Using Video Telehealth to Facilitate Inhaler Training in Rural Patients with Obstructive Lung Disease. Telemed J E Health. 2019;25(3):230 to 236. doi:10.1089/tmj.2017.0330Pinnock H, McKenzie L, Price D, Sheikh A. Cost-effectiveness of telephone or surgery asthma reviews: economic analysis of a randomized controlled trial. Br J Gen Pract. 2005;55(511):119 to 124.Pinnock H, McKenzie L, Price D, Sheikh A. Cost-effectiveness of telephone or surgery asthma reviews: economic analysis of a randomized controlled trial. Br J Gen Pract. 2005;55(511):119 to 124. 
      Pinnock H, Adlem L, Gaskin S, Harris J, Snellgrove C, Sheikh A. Accessibility, clinical effectiveness, and practice costs of providing a telephone option for routine asthma reviews: phase IV controlled implementation study. Br J Gen Pract. 2007;57(542):714 to 722.Pinnock H, Adlem L, Gaskin S, Harris J, Snellgrove C, Sheikh A. Accessibility, clinical effectiveness, and practice costs of providing a telephone option for routine asthma reviews: phase IV controlled implementation study. Br J Gen Pract. 2007;57(542):714 to 722. 
      Portnoy JM, Waller M, De Lurgio S, Dinakar C. Telemedicine is as effective as in-person visits for patients with asthma. Ann Allergy Asthma Immunol. 2016;117(3):241 to 245. doi:10.1016/j.anai.2016.07.012 
     Diabetes educationDebon R, Coleone JD, Bellei EA, Marchi ACBD. Mobile health applications for chronic diseases: A systematic review of features for lifestyle improvement. Diabetes & Metabolic Syndrome: Clinical Research & Reviews. 2019;13(4):2507 to 2512. doi:10.1016/j.dsx.2019.07.016.Izquierdo R, Lagua CT, Meyer S, et al. Telemedicine Intervention Effects on Waist Circumference and Body Mass Index in the IDEATel Project. Diabetes Technology & Therapeutics. 2010;12(3):213 to 220. doi:10.1089/dia.2009.0102.Sood A, Watts SA, Johnson JK, Hirth S, Aron DC. Telemedicine consultation for patients with diabetes mellitus: a cluster randomized controlled trial. J Telemed Telecare. 2018;24(6):385 to 391. doi:10.1177/1357633 × 17704346 
     So CF, Chung JW. Telehealth for diabetes self-management in primary healthcare: A systematic review and meta-analysis. Journal of Telemedicine and Telecare. 2017;24(5):356 to 364. doi:10.1177/1357633 × 17700552. 
     Diet/NutritionOlson CA, McSwain S.D., Curfman AL, Chuo J. The Current Pediatric Telehealth Landscape. Pediatrics. 2018;141(3). doi:10.1542/peds.2017 to 2334van Doorn-van Atten MN, Haveman-Nies A, Pilichowski P, Roca R, de Vries JHM, de Groot CPGM. Telemonitoring to improve nutritional status in community-dwelling elderly: design and methods for process and effect evaluation of a non-randomized controlled trial. BMC Geriatr. 2018;18(1):284. Published 2018 Nov 16. doi:10.1186/s12877-018-0973-2Eakin E, Reeves M, Lawler S, et al. Telephone counseling for physical activity and diet in primary care patients. Am J Prev Med. 2009;36(2):142 to 149. doi:10.1016/j.amepre.2008.09.042 
      Goode AD, Reeves MM, Eakin EG. Telephone-delivered interventions for physical activity and dietary behavior change: an updated systematic review. Am J Prev Med. 2012;42(1):81 to 88. doi:10.1016/j.amepre.2011.08.025 
     Exercise Eakin E, Reeves M, Lawler S, et al. Telephone counseling for physical activity and diet in primary care patients. Am J Prev Med. 2009;36(2):142 to 149. doi:10.1016/j.amepre.2008.09.042 
      Goode AD, Reeves MM, Eakin EG. Telephone-delivered interventions for physical activity and dietary behavior change: an updated systematic review. Am J Prev Med. 2012;42(1):81 to 88. doi:10.1016/j.amepre.2011.08.025 
     Family planning/ContraceptionLengle KL, Mangone ER, Parcesepe AM, Agarwal S, Ippoliti NB. Mobile Phone Interventions for Adolescent Sexual and Reproductive Health: A Systematic Review. Pediatrics. 2016;138(3). doi:10.1542/peds.2016-0884. 
     Martinez KA, Rastogi R, Lipold L, Rothberg MB. Response to requests for contraception in one direct-to-consumer telemedicine service. Contraception. February 2020. doi:10.1016/j.contraception.2020.01.017 
     Growth/developmentTelemedicine in America 2017: Parents Use of Virtual Visits. Nemours Children’s Health System; 2017. https://www.nemours.org/content/dam/nemours/wwwv2/filebox/mediaroom/telehealth-survey-executive-summary-final.pdf. Accessed April 9, 2020. 
     Injury prevention Gielen AC, Bishai DM, Omaki E, et al. Results of an RCT in Two Pediatric Emergency Departments to Evaluate the Efficacy of an m-Health Educational App on Car Seat Use. American Journal of Preventive Medicine. 2018;54(6):746 to 755. doi:10.1016/j.amepre.2018.01.042. 
     Sexually transmitted disease preventionCordova D, Mendoza Lua F, Muñoz-Velázquez J, et al. A multilevel mHealth drug abuse and STI/HIV preventive intervention for clinic settings in the United States: A feasibility and acceptability study. PLoS One. 2019;14(8):e0221508. Published 2019 Aug 22. doi:10.1371/journal.pone.0221508Horberg MA, Blank JG, Rubenstein KB, et al. Impact of Alternative Encounter Types on HIV Viral Suppression Rates in an Integrated Health System. AIDS Patient Care STDS. 2018;32(11):425 to 431. doi:10.1089/apc.2018.0079Touger R, Wood BR. A Review of Telehealth Innovations for HIV Pre-Exposure Prophylaxis (PrEP). Current HIV/AIDS Reports. 2019;16(1):113 to 119. doi:10.1007/s11904-019-00430-z.
     Muessig KE, Nekkanti M, Bauermeister J, Bull S, Hightow-Weidman LB. A systematic review of recent smartphone, Internet and Web 2.0 interventions to address the HIV continuum of care. Curr HIV/AIDS Rep. 2015;12(1):173 to 190. doi:10.1007/s11904-014-0239-3 
     Prado G, Estrada Y, Rojas LM, et al. Rationale and design for eHealth Familias Unidas Primary Care: A drug use, sexual risk behavior, and STI preventive intervention for hispanic youth in pediatric primary care clinics. Contemp Clin Trials. 2019;76:64 to 71. doi:10.1016/j.cct.2018.11.005 
     Stress managementHoerster KD, Jakupcak M, Stephenson KR, et al. A pilot trial of telephone-based collaborative care management for PTSD among Iraq/Afghanistan war veterans. Telemed J E Health. 2015;21(1):42 to 47. doi:10.1089/tmj.2013.0337 
     Possemato K, Bishop TM, Willis MA, Lantinga LJ. Healthcare Utilization and Symptom Variation Among Veterans Using Behavioral Telehealth Center Services. The Journal of Behavioral Health Services & Research. 2013;40(4):416 to 426. doi:10.1007/s11414-013-9338-year. 
     Substance abuse counseling Kalapatapu RK, Ho J, Cai X, Vinogradov S, Batki SL, Mohr DC. Cognitive-behavioral therapy in depressed primary care patients with co-occurring problematic alcohol use: effect of telephone-administered versus face-to-face treatment-a secondary analysis. J Psychoactive Drugs. 2014;46(2):85 to 92. doi:10.1080/02791072.2013.876521Shepard DS, Daley MC, Neuman MJ, Blaakman AP, McKay JR. Telephone-based continuing care counseling in substance abuse treatment: Economic analysis of a randomized trial. Drug Alcohol Depend. 2016;159:109 to 116. doi:10.1016/j.drugalcdep.2015.11.034Shepard DS, Daley MC, Neuman MJ, Blaakman AP, McKay JR. Telephone-based continuing care counseling in substance abuse treatment: Economic analysis of a randomized trial. Drug Alcohol Depend. 2016;159:109 to 116. doi:10.1016/j.drugalcdep.2015.11.034 
     Tobacco use/ExposureE. Lichtenstein, R.E. Glasgow, H.A. Lando, D.J. Ossip-Klein, S.M. Boles, Telephone counseling for smoking cessation: rationales and meta-analytic review of evidence, Health Education Research, Volume 11, Issue 2, June 1996, Pages 243 to 257, https://doi.org/10.1093/her/11.2.243Richter KP, Shireman TI, Ellerbeck EF, et al. Comparative and cost effectiveness of telemedicine versus telephone counseling for smoking cessation [published correction appears in J Med Internet Res. 2015;17(6):e124. Catley, Delwyn [Added]]. J Med Internet Res. 2015;17(5):e113. Published 2015 May 8. doi:10.2196/jmir.3975Stead LF, Hartmann-Boyce J, Perera R, Lancaster T. Telephone counseling for smoking cessation. Cochrane Database of Systematic Reviews. December 2013. doi:10.1002/14651858.cd002850.pub3
     Kruse G, Park ER, Shahid NN, Abroms L, Haberer JE, Rigotti NA. Combining Real-Time Ratings With Qualitative Interviews to Develop a Smoking Cessation Text Messaging Program for Primary Care Patients. JMIR Mhealth Uhealth. 2019;7(3):e11498. Published 2019 Mar 26. doi:10.2196/11498Matkin W, Ordóñez-Mena JM, Hartmann-Boyce J. Telephone counseling for smoking cessation. Cochrane Database of Systematic Reviews. February 2019. doi:10.1002/14651858.cd002850.pub4.
     Buller DB, Borland R, Bettinghaus EP, Shane JH, Zimmerman DE. Randomized trial of a smartphone mobile application compared to text messaging to support smoking cessation. Telemed J E Health. 2014;20(3):206 to 214. doi:10.1089/tmj.2013.0169 
     Weight reductionSmith E, Bradbury K, Scott L, Steele M, Little P, Yardley L. Providing online weight management in Primary Care: a mixed methods process evaluation of healthcare practitioners' experiences of using and supporting patients using POWeR. Implement Sci. 2017;12(1):69. Published 2017 May 25. doi:10.1186/s13012-017-0596-6Davis AM, James RL, Boles RE, Goetz JR, Belmont J, Malone B. The use of TeleMedicine in the treatment of pediatric obesity: feasibility and acceptability. Matern Child Nutr. 2011;7(1):71 to 79. doi:10.1111/j.1740 to 8709.2010.00248.xDavis AM, Sampilo M, Gallagher KS, Landrum Y, Malone B. Treating rural pediatric obesity through telemedicine: outcomes from a small randomized controlled trial. J Pediatr Psychol. 2013;38(9):932 to 943. doi:10.1093/jpepsy/jst005 
      Batsis JA, Pletcher SN, Stahl JE. Telemedicine and primary care obesity management in rural areas - innovative approach for older adults?. BMC Geriatr. 2017;17(1):6. Published 2017 Jan 5. doi:10.1186/s12877-016-0396-xAppel LJ, Clark JM, Yeh HC, et al. Comparative effectiveness of weight-loss interventions in clinical practice. N Engl J Med. 2011;365(21):1959 to 1968. doi:10.1056/NEJMoa1108660 
       Izquierdo R, Lagua CT, Meyer S, et al. Telemedicine intervention effects on waist circumference and body mass index in the IDEATel project. Diabetes Technol Ther. 2010;12(3):213 to 220. doi:10.1089/dia.2009.0102   
  • UnweightedWeighted
    n%n%
    Metropolitan Statistical AreaMSA62393.430650892.7
    Non-MSA546.6240977.3
    Region of practice location
    Northeast14225.46666620.2
    Midwest14617.97094621.5
    South25540.210859532.9
    West13416.58439825.5
    Practice Ownership
    Physician or physician group51974.7242,05873.2
    Medical/academic health center; Community health center6110.533,11510.0
    Insurance company, health plan, or HMO;629.238,10911.5
    Unknown355.7173235.3
    677100.0330,605100.0

    • Source: Author’s Analysis of the 2016 National Survey of Ambulatory Medical Care Survey weighted by physician weight. (n = 677 equivalent to 330,605 nationally representative sample of physicians).

    • MSA, Metropolitan statistical area; HMO, Health maintenance organization.

Back to top

In this issue

Print
Download PDF
Article Alerts
Email Article
Citation Tools

Jump to section

Keywords