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

Yalda Jabbarpour, MD; Anuradha Jetty, MPH; Matthew Westfall; John Westfall, MD MPH

Corresponding Author: Yalda Jabbarpour, MD; The Robert Graham Center for Policy Studies in Primary Care. Email: yjabbarpour@aafp.org

Section: Brief Report

| FULL PDF |       | TABLE 1 |       | TABLE 2 |       | APPENDIX |

The COVID 19 pandemic has resulted in a rapid shift to telehealth and many services that need in-person care have been avoided. Yet, as practices and payment policies return to a new normal, there will be many questions about what proportion of visits should be done in-person vs telehealth. Using the 2016 National Ambulatory Medical Survey we estimated what proportion of visits were amenable to telehealth prior to COVID-19 as a guide. We divided services into those that needed in-person care and those that could be done via telehealth. Any visit that included at least one service where in-person care was needed was counted as an in-person only visit. We then calculated what proportion of reported visits and services in 2016 could have been provided via telehealth, as well as what proportion of in-person only services were done by primary care. We found that 66% of all primary care visits reported in NAMCS in 2016 required an in-person service. 90% of all wellness visits and immunizations were done in primary care offices, as were a quarter of all pap smears. As practices reopen, patient will need to catch up on many of the in-person only visits that were postponed such as pap smears and wellness visits. At the same time, patients and clinicians now accustomed to telehealth, may have reservations about returning to in-person only visits. Our estimates may provide a guide to practices as they navigate how to deliver care in a post COVID-19 environment.

COVID-19 AHEAD OF PRINT

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