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Brief ReportBrief Report

Not Telehealth: Which Primary Care Visits Need In-Person Care?

Yalda Jabbarpour, Anuradha Jetty, Matthew Westfall and John Westfall
The Journal of the American Board of Family Medicine February 2021, 34 (Supplement) S162-S169; DOI: https://doi.org/10.3122/jabfm.2021.S1.200247
Yalda Jabbarpour
From the Robert Graham Center for Policy Studies in Primary Care, Washington, DC (YJ, AJ, JW); Virginia Commonwealth University School of Medicine, Richmond, VA (MW).
MD
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Anuradha Jetty
From the Robert Graham Center for Policy Studies in Primary Care, Washington, DC (YJ, AJ, JW); Virginia Commonwealth University School of Medicine, Richmond, VA (MW).
MPH
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Matthew Westfall
From the Robert Graham Center for Policy Studies in Primary Care, Washington, DC (YJ, AJ, JW); Virginia Commonwealth University School of Medicine, Richmond, VA (MW).
BA
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John Westfall
From the Robert Graham Center for Policy Studies in Primary Care, Washington, DC (YJ, AJ, JW); Virginia Commonwealth University School of Medicine, Richmond, VA (MW).
MD, MPH
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Article Figures & Data

Tables

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    Appendix Table 1.

    Physical Presence Not 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
    Creatinine/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
    Urinalysis/Urine dipstick
    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
    SkinElectroencephalogram (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; HIV, Human Immunodeficiency Virus; HPV, Human Papillomavirus; PSA, Prostate Specific Antigen; CT, Computed Tomography; MRI, Magnetic Resonance Imaging; STD, Sexually Transmitted Disease; EKG, electrocardiogram.

    • View popup
    Table 1.

    Proportion of Encounters That Require Physician Presence (Includes Immunizations and Well Child Visits)

    Physician Presence RequiredAll Physicians(n = 850,695,621)Primary Care Physicians(n = 394,218,001))
    N%N%
    Yes580,027,03469258,431,19966
    No266,748,17631134,797,21834
    • Source: National Ambulatory Medical Care Survey 2016.

    • View popup
    Table 2.

    Distribution of Services That Require Physical Presence of Physician

    All Specialties)Primary Care Physician (PCP))
    N = 850,695,621)N = 394,218,001)% provided by PCP)
    ))
    ServicesN%N%
    Examinations
     Breast exam30,023,0084.010,623,6913.135.4
     Foot exam27,548,6543.719,086,4605.669.3
     Neurologic117,668,32015.760,303,23217.751.2
     Pelvic37,347,1525.08,589,8122.523.0
     Rectal14,871,2022.06,556,6281.944.1
     Retinal135,895,10418.267,560,99219.849.7
    Lab tests
     Throat culture7,938,9891.07,641,9452.096.3
     Rapid strep test19,126,7443.017,694,1285.092.5
     Pap test22,644,4002.67,096,6811.731.3
    Procedures
    N%N%
     Audiometry10,834,2291.41,087,7992.210.0
     Biopsy provided7,845,3351.8124,3990.31.6
     Cardiac stress test7,060,0850.91,823,2230.525.8
     Cryosurgery (cryotherapy)/destruction of tissue11,794,6851.6914,7580.37.8
     Electrocardiogram (ECG or EKG)41,185,7445.511,221,4293.327.2
     Electroencephalogram (EEG)1,363,2780.2169,9620.012.5
     Electromyogram (EMG)3,469,6100.5478,0960.113.8
     Excision of tissue provided4,605,4075.6544,5020.211.8
     Fetal monitoring6,696,8670.900.00.0
     Peak flow2,483,4940.3851,8630.334.3
     Sigmoidoscopy provided426,6700.1360,1960.184.4
     Spirometry12,203,9331.63,851,8411.131.6
     Tonometry4,594,3170.6122,7300.02.7
     Tuberculosis skin testing (PPD)1,881,2070.31,202,3980.463.9
     Upper gastrointestinal endoscopy/EGD provided1,054,7860.1536,6970.250.9
    Treatments
    N%N%
     Cast/splint/wrap5,824,0300.81,429,8630.424.6
     Complementary and alternative medicine (CAM)682,9210.1297,2180.143.5
     Durable medical equipment8,054,4561.11,635,6650.520.3
     Home health care2,254,9390.31,804,9070.580.0
     Occupational therapy848,8400.1227,2040.126.8
     Physical therapy22,295,3323.05,587,0391.625.1
     Radiation therapy252,6600.000.00.0
     Wound care12,809,5931.72,551,8710.719.9
     Immunizations9,370,3901.18,852,0572.094.0
     Annual wellness visits77,700,0009.073,800,00019.095.0
    • Source: National Ambulatory Medical Care Survey 2016.

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The Journal of the American Board of Family  Medicine: 34 (Supplement)
The Journal of the American Board of Family Medicine
Vol. 34, Issue Supplement
February 2021
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Not Telehealth: Which Primary Care Visits Need In-Person Care?
Yalda Jabbarpour, Anuradha Jetty, Matthew Westfall, John Westfall
The Journal of the American Board of Family Medicine Feb 2021, 34 (Supplement) S162-S169; DOI: 10.3122/jabfm.2021.S1.200247

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Not Telehealth: Which Primary Care Visits Need In-Person Care?
Yalda Jabbarpour, Anuradha Jetty, Matthew Westfall, John Westfall
The Journal of the American Board of Family Medicine Feb 2021, 34 (Supplement) S162-S169; DOI: 10.3122/jabfm.2021.S1.200247
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